孕妇血清IgG抗体效价、新生儿网织红细胞和血红蛋白水平在新生儿ABO溶血病早期诊断中的应用价值研究

Study of maternal serum IgG antibody titer,neonatal reticulocyte and hemoglobin levels in early diagnosis of neonatal ABO hemolytic disease

目的:探讨孕妇血清IgG抗体效价联合新生儿网织红细胞(Ret)以及血红蛋白(Hb)水平检测在新生儿ABO溶血(ABO-HDN)早期诊断中的应用效果。方法:选取商丘市第一人民医院2021年5月至2023年9月收治的102例正常分娩的孕妇为研究对象,根据新生儿ABO-HDN筛查结果将产妇和新生儿分为ABO-HDN组(50例)和非ABO-HDN组(52例)。分析比较ABO-HDN组和非ABO-HDN组孕妇血清IgG抗体效价、新生儿Ret、Hb水平。采用受试者工作特征曲线(ROC曲线)评估血清IgG抗体效价、新生儿Ret和Hb水平单一及联合检测诊断ABO-HDN的效能。结果:ABO-HDN组孕妇血清IgG抗体效价≥1∶64构成比明显高于非ABO-HDN组(P<0.05);ABO-HDN组新生儿Ret水平明显比非ABO-HDN组高,Hb水平则显著低于非ABO-HDN组(P<0.05);孕妇血清IgG抗体效价、新生儿Ret及Hb水平诊断ABO-HDN的ROC曲线下面积(AUC)分别为0.826、0.725、0.657,三者联合检测的AUC位0.907,联合检测的诊断价值最高(P<0.05)。结论:ABO-HDN患儿的母亲分娩前血清IgG抗体效价和新生儿Ret、Hb水平均呈现异常,三者联合检测在ABO-HDN早期诊断中具有较好的诊断价值。

Objective:To explore the application effect of maternal serum IgG antibody titer combined with neonatal Ret and Hb levels in the early diagnosis of ABO-HDN.Methods:A total of 102 pregnant women with normal delivery admitted to the First People’s Hospital of Shangqiu from May 2021 to September 2023 were selected as the study objects.According to the newborn ABO-HDN screening results,the pregnant women and newborns were divided into ABO-HDN group(n=50)and non-ABO-HDN group(n=52).Serum IgG antibody titer,Ret and Hb levels of neonates in ABO-HDN group and non-ABO-HDN group were analyzed and compared.Receiver operating characteristic curve(ROC curve)was used to evaluate the efficacy of serum IgG antibody titer,neonatal Ret and Hb levels in the diagnosis of ABO-HDN.Results:The proportion of serum IgG antibody titer≥1:64 in ABO-HDN group was significantly higher than that in non-ABO-HDN group(P<0.05).The Ret level in ABO-HDN group was significantly higher than that in non-ABO-HDN group,while Hb level was significantly lower than that in non-ABO-HDN group(P<0.05).Area under the ROC curve(AUC)of serum IgG antibody titer in pregnant women,Ret and Hb levels in newborns were 0.826,0.725 and 0.657,respectively,and the AUC level of the three combined detection was 0.907,indicating the highest diagnostic value(P<0.05).Conclusions:The serum IgG antibody titer of mothers before delivery and Ret and Hb levels of newborns are abnormal,and the combined detection of the three has a good diagnostic value in the early diagnosis of ABO-HDN.