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目的了解新生儿黄疸患儿中溶血病(HDN)发病情况。方法对526例新生儿黄疸患儿采用盐水法检测ABO、Rh血型,采用直接抗人球蛋白试验(DAT)、游离抗体试验、抗体释放试验检测,分析其结果阳性率和临床符合率,并进行统计学分析。结果诊断为新生儿溶血病180例,其中ABO血型系统不合的169例,Rh血型系统不合的11例;新生儿黄疸血清学检测阳性率及在HDN诊断中的临床符合率分别为22例(4.2%)和22/180例(12.2%)、368例(70.0%)和368/180例(204.4%)、180例(34.2%)和100.0%,三者间比较均有显著差异(P<0.05)。结论血型血清学检测对新生儿溶血病的诊断具有重要的临床价值;ABO-HDN的患儿DAT结果大多数是阴性,游离抗体试验在HDN诊断中假阳性发生率较高,只能作为参考而不能作为诊断依据,抗体释放试验是诊断ABO-HDN最灵敏、最可靠的方法。
Objective To understand the incidence of hemolytic disease (HDN) in neonates with jaundice. Methods 526 neonates with jaundice were enrolled in this study. The ABO and Rh blood types were detected by saline method. The direct anti-human globulin test (DAT), free antibody test and antibody release test were used to detect the positive rate and clinical coincidence rate. Statistical analysis. Results The diagnosis of neonatal hemolytic disease in 180 cases, including 169 cases of ABO blood group incompatibility and 11 cases of Rh blood group incompatibility. The positive rate of neonatal jaundice and the clinical coincidence rate in diagnosis of HDN were 22 cases (4.2 %), 22/180 cases (12.2%), 368 cases (70.0%) and 368/180 cases (204.4%), 180 cases (34.2%) and 100.0% ). Conclusion Serological detection of blood group has important clinical value in the diagnosis of hemolytic disease of newborn. Most of the children with ABO-HDN have negative DAT results. The incidence of false positives in HDN diagnosis of free antibody test is high, which can only be used as reference Not as a diagnostic basis, antibody release test is the most sensitive and reliable method to diagnose ABO-HDN.