探讨新生儿溶血病血清学检测在HDFN诊断中的应用价值

Exploring the Application Value of Serological Detection of Neonatal Hemolytic Disease in the Diagnosis of HDFN

目的分析在新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)中血清学检测结果的应用价值。方法选取2019年1月—2022年12月在龙岩市第二医院新生儿科接受治疗的高胆红素血症患儿100例,对其进行抗体释放试验、游离抗体试验、直接抗人球蛋白试验、不规则抗体筛查、血型鉴定检测,对比产前母体采血送检结果与产后婴儿采血送检结果差异。结果100例患儿中,58例患儿出现母婴血型不合,其中ABO血型系统50例,Rh血型系统8例。ABO血型系统HDFN发生率显著高于Rh血型系统(P<0.05);50例ABO血型系统母婴不合者中,O-A型HDFN发生率显著高于O-B型(P<0.05)。31例HDFN患儿的血清学检测结果中,单独抗体放散试验为阳性的HDFN患儿占比率显著高于其他类型(P<0.05)。产前检测IgG抗A或抗B效价结果与产后采血对比,产前检测准确率为90.32%。结论血清学检测结果在HDFN诊断中具有一定的辅助价值,在1周内检测阳性率最高。

Objective To analyze the application value of serological test results in neonatal hemolytic disease of the fe tus and newborn(HDFN).Methods A total of 100 children with hyperbilirubinemia who received treatment in the department of neonatology,the Second Hospital of Longyan from January 2019 to December 2022 were selected.Antibody release test,free antibody test,direct anti-human globulin test,irregular antibody screening and blood group identification test were carried out,and then the results of prenatal maternal blood collection and postpartum infant blood collection were compared.Results of the 100 cases,58 cases had maternal fetal blood group incompatibility,including 50 cases of ABO blood group system and 8 cases of Rh blood group system.The incidence of HDFN in ABO blood group system was significantly higher than that in Rh blood group system(P<0.05).In 50 cases of ABO blood group system with maternal infant incompatibility,the incidence of O-A type HDFN was significantly higher than that of O-B type HDFN(P<0.05).Among the serological test results of 31 HDFN patients,the proportion of HDFN patients with positive individual antibody dispersion test were significantly higher than that of other types(P<0.05).Compared with postpartum blood collection,the accuracy of prenatal detection of IgG anti-A or anti-B titer was 90.32%.Conclusion The serological test results have certain auxiliary value in the diagnosis of HDFN.