摘要
目的探讨疑似新生儿溶血病(HDN)患儿抗体三项检测结果,以期为疾病早期诊断及治疗提供重要指导。方法选取2020年2月至2022年1月经赣州市南康区第一人民医院输血科送检疑似为HDN的586例患儿血清标本作为研究对象,均进行抗体三项检测(即直接试验、游离抗体试验、抗体释放试验),以临床确诊为金标准,根据检测结果统计HDN阳性率,分析HDN阳性率与血型、性别及送检日龄的关联。结果586例疑似HDN患儿金标准检出ABO-HDN 200例、Rh-HDN 7例。其中,抗体三项检测中直接试验检出ABO-HDN阳性11例,检出率为5.50%;游离抗体试验检出ABO-HDN阳性123例,检出率为61.50%;抗体释放试验检出ABO-HDN阳性199例,检出率为99.50%。三种检测的ABO-HDN检出率比较,差异有统计学意义(P<0.05);抗体释放试验的ABO-HDN检出率高于游离抗体试验、直接试验,差异有统计学意义(P<0.017)。以母亲血型O型(共410例)为对象,予以血型分组,O-A型224例、O-B型186例,患儿A型、B型ABO-HDN阳性率比较,差异无统计学意义(P>0.05);按性别分组,男318例、女268例,男性、女性HDN阳性率分别为33.65%、37.31%,两者比较,差异无统计学意义(P>0.05);按送检日龄分组,送检日龄≤3 d(n=376)、>3~7 d(n=137)、>7 d(n=73)的HDN阳性率分别为39.63%、29.20%、24.66%,三者比较,差异有统计意义(P<0.05);送检日龄>7 d、>3~7 d阳性率均低于送检日龄≤3 d,差异有统计学意义(P<0.017)。结论抗体三项检测中抗体释放试验检出HDN最为准确。性别、血型对试验结果无明显影响,但送检日龄可产生较大影响,当发现HDN相关疑似指征时,应在3 d内收集血清标本及时送检。
Objective To investigate the three antibody detection results in children with suspected hemolytic disease of newborn(HDN),in order to provide important guidance for the early diagnosis and treatment of the disease.Methods A total of 586 serum samples of children suspected to be HDN were collected from the Department of Blood Transfusion of the First People's Hospital of Nankang District in Ganzhou City from February 2020 to January 2022.All of them were tested by three antibody tests(namely direct test,free antibody test and antibody release test).Clinical diagnosis was taken as the gold standard,and HDN positive rate was calculated according to the test results.The positive rate of HDN was correlated with blood type,gender and age of examination.Results In 586 suspected children with HDN,200 cases of ABO-HDN and 7 cases of Rh-HDN were detected by gold standard.Among the three antibody tests,11 cases were directly detected ABO-HDN positive,the detection rate was 5.50%.123 cases of ABO-HDN positive were detected by free antibody test,the detection rate was 61.50%.ABO-HDN was positive in 199 cases by antibody release test,the detection rate was 99.50%.The detection rate of ABO-HDN of the three kinds of detection was statistically significant(P<0.05).The ABO-HDN detection rate of antibody release test was higher than that of free antibody test and direct test,and the differences were statistically significant(P<0.017).Mothers with blood group O(410 cases in total)were divided into blood group groups,with 224 cases of O-A and 186 cases of O-B.There was no significant difference in the ABO-HDN positive rate between type A and B(P>0.05).The positive rates of HDN in male and female were 33.65%and 37.31%respectively.There was no significant difference between the two groups(P>0.05).The positive rates of HDN≤3 d(n=376),>3-7 d(n=137),>7 d(n=73)were 39.63%,29.20%,24.66%,respectively,and the differences among the three groups were statistically significant(P<0.05).The positive rates of age>7 d and>3-7 d were lower than that of≤3 d,and the differences were statistically significant(P<0.017).Conclusion The antibody release test is the most accurate in detecting HDN among the three antibody tests.Gender and blood group had no significant influence on the test results,but the age of submitting the test had a greater influence.When suspected indications related to HDN were found,serum samples should be collected within 3 days and submitted in time.
作者
石礼红
李丽
刘石长
欧阳贵平
SHI Lihong;LI Li;LIU Shichang;OUYANG Guiping(Department of Blood Transfusion,the First People's Hospital of Nankang District in Ganzhou City,Jiangxi Province,Ganzhou 341400,China)
出处
《中国当代医药》
CAS
2023年第33期123-127,共5页
China Modern Medicine
基金
江西省赣州市指导性科技计划项目(GZ2021ZSF452)。
