新生儿ABO溶血病实验室血清学检测结果分析

Analysis of serological test results of ABO neonatal hemolytic disease

目的通过对新生儿ABO溶血病实验室血清学检测结果进行分析,为临床诊断和治疗提供实验室依据。方法对2017年5月至2021年4月在广州医科大学附属第五医院住院的500例疑似新生儿ABO溶血病的新生儿血液标本采用微柱凝胶法进行ABO、Rh血型鉴定及红细胞直接抗人球蛋白试验(DAT)、游离抗体试验、红细胞抗体放散试验溶血3项检测。结果500例患儿中有273例血清学实验阳性,阳性率为54.6%,其中A型血患儿的阳性检出率比B型血的高,两者差异有统计学意义(P<0.05);273例阳性患儿的溶血3项试验中DAT阳性率为8.8%(24/273),游离抗体试验阳性率为77.3%(211/273),红细胞抗体放散试验阳性率为100%(273/273);女患儿血清学实验阳性率高于男患儿,两者差异有统计学意义(P<0.05);不同日龄新生儿ABO溶血病阳性检出率不同,差异有统计学意义(P<0.05),日龄≤3 d的高于日龄4~7 d和日龄>7 d,日龄4~7 d的高于日龄>7 d,差异有统计学意义(P<0.0167)。结论血清学溶血3项试验能为新生儿ABO溶血病的诊断提供可靠的实验室依据,红细胞抗体放散试验是3项试验中最具价值的一项试验。新生儿的血型、新生儿性别和日龄对实验室结果有一定影响。

Objective To provide laboratory evidence for clinical diagnosis and treatment,the laboratory serological test results of neonatal ABO hemolytic disease were analyzed.Methods From May 2017 to April 2021,500 neonatal blood samples suspected of neonatal ABO hemolytic disease who were hospitalized in the Fifth Affiliated Hospital of Guangzhou Medical University were used microcolumn gel method for ABO and Rh blood group identification and direct anti-human globulin test(DAT),free antibody test,and erythrocyte antibody emission test for hemolysis.Results Among the 500 children,there were 273 positive serological tests with a positive rate of 54.6%.Among them,the positive rate of children with type A blood was higher than that of type B blood,and the difference between the two was statistically significant(P<0.05).The positive rate of DAT was 8.8%(24/273),the positive rate of free antibody test was 77.3%(211/273),the positive rate of erythrocyte antibody emission test was 100%(273/273),the positive rate of serological test in female children was higher than that in male children,and the difference was statistically significant(P<0.05),the positive detection rate of ABO hemolytic disease in newborns of different ages was different,and the difference was statistically significant(P<0.05).The rate in 3 days of age was higher than that of 4 to 7 days,and those with a daily age of 4~7d are higher than the daily age>7 d,the difference was statistically significant(P<0.0167).Conclusions The three serological hemolysis tests can provide a reliable laboratory basis for the diagnosis of neonatal ABO hemolytic disease.The red blood cell antibody release test is the most valuable test among the three tests.The blood type,gender and age of the newborn have certain influence on the laboratory results.