402例疑似新生儿ABO溶血病血清学检测结果分析

Analysis of Serological Test Results of 402 Cases of Suspected Neonatal ABO Hemolytic Disease

目的对疑似新生儿溶血病(hemolytic disease of newborn,HDN)患儿进行溶血三项的筛查,了解HDN的检出率在患儿血型、性别、出生日龄以及母亲妊娠次数的分布情况。方法收集淄博市妇幼保健院402例疑似ABO-HDN患儿及其母亲的血液标本,进行血型鉴定、母亲进行不规则抗体筛查、患儿进行溶血三项试验(直接抗人球蛋白试验、游离抗体试验及放散试验),并对检测结果进行分析。结果在402例疑似ABO-HDN患儿中,证实为该病的有222例,占55.22%。A型和B型患儿ABO-HDN阳性率分别为62.86%、49.34%;男性患儿与女性患儿ABO-HDN的阳性率分别为48.06%、63.73%;出生日龄≤1 d的患儿阳性率为77.23%;2~3 d的患儿阳性率为57.46%;>3 d的患儿阳性率为33.33%;母亲第一胎与非第一胎ABO-HDN的阳性率分别为47.40%、61.14%。结论不同血型、性别的患儿,ABO-HDN的阳性检出率有一定差别;患儿的出生日龄以及患儿母亲怀孕次数的不同,ABO-HDN的阳性检出率也有一定差别。

Objective Newborns with suspected neonatal hemolytic disease are screened for three hemolytic diseases.To understand the distribution of HDN detection rate in the blood type,gender,birth date age and number of pregnancies of the mother.Methods Blood samples from 402 suspected ABO-HDN newborns and their mothers were collected from our hospital.Both specimens were identified for blood type and the mother was screened for irregular antibodies.Neonatal specimens were tested for hemolytic blood(direct anti-human globulin test,free antibody test,and release test)and analyzed.Results There were 222 accounting for 55.22%confirmed cases of the disease in 402 neonates with suspected ABO-HDN.The positive rates of ABO-HDN in newborns with blood type A and blood type B were 62.86%and 49.34%,respectively.The positive rates of ABO-HDN in male and female newborns were 48.06%and 63.73%,respectively.The positive rate of newborns with a birth age of≤1 day was 77.23%.The positive rate of newborns at 2~3 days was 57.46%;the positive rate of newborns>3 days was 33.33%.The positive rates of ABO-HDN in mothers with first pregnancy and non-first pregnancy were 47.40%and 61.14%,respectively.Conclusion The positive detection rate of ABO-HDN was different in children with different blood types and genders.The positive detection rate of ABO-HDN was also different according to the age of birth and the number of pregnancies.