新生儿溶血病患儿血型分布及血清学检测结果分析

Analysis of blood group distribution and serological test results of newborn hemolytic disease

目的分析新生儿溶血病(HDN)血清学检测结果。方法选取厦门市妇幼保健院新生儿科2015年1月—2017年7月收治的高胆红素血症患儿1 568例,检测母婴血型,进行直接抗人球蛋白试验、游离抗体试验及抗体放散试验。记录HDN患儿血型分布、HDN患儿三项溶血试验结果,分析HDN患儿阳性率与标本采集时间关系。结果 ABO血型系统阳性率高于Rh血型系统(P<0.05)。A、B型患儿阳性率比较,差异无统计学意义(P>0.05)。确诊的1 082例HDN患儿中,直接抗人球蛋白试验阳性为344例(31.79%);游离抗体试验阳性为832例(76.89%);抗体放散试验均为阳性。标本采集时间为0～3 d、4～7 d、>7 d HDN患儿阳性率比较,差异有统计学意义(P<0.05);标本采集时间为0～3 d的阳性率高于其他采集时间(P<0.05)。结论 HDN主要发生于ABO血型系统,其次为Rh血型系统,A、B型HDN患儿发病率相当,但抗体放散试验的敏感度较高,是诊断HDN的有力证据,患儿血样应尽早送检,提高HDN阳性率。

Objective To analyse the blood group distribution and serological test results of newborn hemolytic disease.Methods A total of 1 568 cases of hyperbilirubinemia were admited in the Department of Neonatal,Xiamen Maternal and Pediatric Hospital from January 2015 to July 2017,which were selected to detect maternal and infant blood groups,and direct anti-human globulin test,free antibody test and antibody diffusion test were carried out.The blood group distribution and hemolysis test results of HDN children were recorded,and the relationship between the positive rate of HDN children,the standard collection time was analyzed.Results The positive rate of ABO blood group system was higher than Rh blood group system(P<0.05).There was no significant difference in the positive rate between type A and B children(P>0.05).Among 1 082 children with HDN,344(31.79%) were positive for direct anti-human globulin test,832(76.89%) were positive for free antibody test and all were positive for antibody diffusion test.There was significant difference in the positive rate of HDN between 0-3 days,4-7 days and >7 days(P<0.05),and the positive rate of HDN between 0-3 days was higher than other collecting time(P<0.05).Conclusion HDN mainly occurs in ABO blood group system,followed by Rh blood group system.The incidence of type A and B HDN is similar,but the sensitivity of antibody diffusion test is the most powerful evidence for the diagnosis of HDN.The blood samples of children should be sent for examination as soon as possible to improve the positive rate of HDN and promote the early recovery of children.