溶血三项联合网织红细胞、血清总胆红素检测对新生儿溶血病早期诊断的临床价值

Clinical value of three hemolysis tests combined with reticulocyte and serum total bilirubin in the early diagnosis of neonatal hemolytic disease

目的探讨溶血三项联合网织红细胞、血清总胆红素检测对新生儿溶血病早期诊断的临床价值。方法选取2022年3月-2023年2月收治的80例疑似新生儿溶血病患儿作为研究对象,按照临床综合确诊结果将其分为非新生儿溶血组(25例)和新生儿溶血组(55例),所有患儿均接受溶血三项、网织红细胞、血清总胆红素指标检测,对比两组患儿检测结果,并计算溶血三项联合网织红细胞、血清总胆红素检测效能。结果溶血三项检测诊断新生儿溶血组共47例确诊,非新生儿溶血组共19例确诊;新生儿溶血病血清总胆红素、网织红细胞高于非新生儿溶血病患儿,差异有统计学意义(P<0.05);溶血三项+血清总胆红素+网织红细胞检测灵敏度为98.18%、特异度为96.00%、阳性预测值为98.18%、阴性预测值96.00%高于溶血三项检测敏感度85.45%、特异度76.00%、阳性预测值88.68%、阴性预测值70.37%,差异有统计学意义(P<0.05)。结论溶血三项联合网织红细胞、血清总胆红素检测判定新生儿溶血病的效能较高,可为临床早期确诊新生儿溶血病提供主要指标。

Objective To explore the clinical value of three hemolytic tests combined with reticulocyte and serum total bilirubin in the early diagnosis of neonatal hemolytic disease.Methods 80 children with suspected hemolytic disease of the newborn admitted from March 2022 to February 2023 were selected as the study subjects.They were divided into non neonatal hemolysis group(25 cases)and neonatal hemolysis group(55 cases)according to the comprehensive clinical diagnosis results.Each child received three tests for hemolysis,reticulocyte,and serum total bilirubin.The test results of the two groups were compared,and the combined reticulocyte detection efficiency of serum total bilirubin.Results A total of 47 cases in the neonatal hemolysis group and 19 cases in the non neonatal hemolysis group were diagnosed by the three hemolysis tests;the serum total bilirubin and reticulocyte in neonatal hemolytic disease were significantly higher than those in non neonatal hemolytic disease(P<0.05).The sensitivity,specificity,positive predictive value,and negative predictive value of the three hemolytic tests,serum total bilirubin,and reticulocytes were 98.18%,96.00%,98.18%,and 96.00%,respectively;the sensitivity,specificity,positive predictive value,and negative predictive value of the three hemolysis tests were 85.45%,76.00%,88.68%,and 70.37%,respectively.The former was higher than the latter,and the difference was statistically significant(P<0.05).Conclusion The combination of three hemolysis tests,reticulocyte and serum total bilirubin,is highly effective in the diagnosis of neonatal hemolytic disease,and can provide a major indicator for early clinical diagnosis of neonatal hemolytic disease.