血清学指标及IgG抗A/B抗体效价与新生儿溶血病严重程度的关系分析

Analysis of the Relationship between Serological Indexes,IgG Anti-A/B Antibody Titer and the Severity of Neonatal Hemolytic Disease

目的:分析血清学指标及IgG型抗A/B抗体效价与新生儿溶血病(HDN)严重程度的关系。方法:选取2020年1月—2022年12月上饶市人民医院收治的82例HDN患儿为研究对象,分析游离试验与放散试验结果,并进行不规则抗体筛查、测定血型抗体效价及检测血清学指标[血清总胆红素(STB)、非结合胆红素(UCB)、红细胞(RBC)计数、血红蛋白(Hb)、白蛋白(ALB)];比较不同IgG抗A/B抗体效价之间的STB、UCB、RBC、Hb、ALB水平及临床指标;采用Pearson相关性分析RBC、Hb、ALB与STB、UCB的关系;采用Spearman相关性分析IgG抗A/B抗体效价与STB、UCB的关系。结果:游离试验检测HDN的阳性率为71.95%、放散试验检测HDN的阳性率为85.37%,两种方式比较差异有统计学意义(P<0.05)。IgG抗A/B血型放散试验抗体效价为1︰1~1︰32,最高为1︰32;游离试验的抗体效价为1︰1~1︰2,最高为1︰2。不同IgG抗A/B抗体效价的STB、UCB、RBC、Hb、ALB水平及新生儿日龄、住院时间比较,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,血清RBC、Hb、ALB与STB、UCB呈负相关。Spearman相关性分析结果显示,IgG抗A/B抗体效价与STB、UCB呈正相关(P<0.05)。结论:IgG抗A/B抗体效价能够测定HDN患儿体内抗A/B抗体水平,血清RBC、Hb、ALB及IgG抗A/B抗体效价能够辅助判断HDN的严重程度。

Objective:To analyze the relationship between serological indexes,IgG anti-A/B antibody titer and the severity of hemolytic disease of newborn(HDN).Method:A total of eighty-two children with HDN admitted to Shangrao People's Hospital from January 2020 to December 2022 were selected as the study objects,and the results of ionization test and release test were analyzed.Irregular antibody screening,blood group antibody titers and serological indicators[serum total bilirubin(STB),unconjugated bilirubin(UCB),red blood cell(RBC)count,hemoglobin(Hb),albumin(ALB)]were detected.The STB,UCB,RBC,Hb,ALB levels and clinical indexes of different IgG anti-A/B antibody titers were compared;Pearson correlation was used to analyze the relationship between RBC,Hb,ALB and STB and UCB.Spearman correlation was used to analyze the relationship between IgG anti-A/B titer and STB and UCB.Result:The positive rate of HDN detected by ionization test was 71.95%,and that by release test was 85.37%,there was statistical significance between the two methods(P<0.05).The titers of IgG anti-A/B blood group release test ranged from 1︰1 to 1︰32,with the highest being 1︰32.The titer of antibody in ionization test was 1︰1 to 1︰2,the highest was 1︰2.The levels of STB,UCB,RBC,Hb,ALB,neonatal age and hospital stay of different IgG anti-A/B antibody titers were statistically significant(P<0.05).Pearson correlation analysis showed that serum RBC,Hb and ALB were negatively correlated with STB and UCB.Spearman correlation analysis showed that the titer of IgG anti-A/B antibody was positively correlated with STB and UCB(P<0.05).Conclusion:IgG anti-A/B antibody titer can determine the level of anti-A/B antibody in children with HDN,and serum RBC,Hb,ALB and IgG anti-A/B antibody titer can assist in judging the severity of HDN.