摘要
目的探讨不同放散试验在新生儿溶血病中的检测效果及对临床治疗预后的指导价值。方法选择2015年3月-2018年4月收治的新生儿溶血病患者75例作为对象,采用冷冻复融放散、三氯乙烯-三氯甲烷放散及热放散试验,统计并分析三种检查阳性率及阳性程度;对于确诊的新生儿溶血病患者在常规疗法基础上联合静脉注射免疫球蛋白治疗,治疗4d后对患者效果进行评估;采用微量胆红素监测仪测定患者治疗前、后总结合胆红素(TB)水平;采用血细胞计数仪测定患者血红细胞计数(RBC);血生化分析仪测定患者治疗前、治疗后4d血红蛋白(Hb)及血细胞比容(HCT)水平;采用流式细胞仪测定患者CD3+、CD4+、CD4+/CD8+水平;统计并统计患者治疗后黄疸消退时间、光疗时间及住院时间。结果冷冻复融放散及热放散试验阳性率及阳性程度比较差异无统计学意义(P>0.05);三氯乙烯-三氯甲烷放散试验阳性率及阳性程度,均低于冷冻复融放散及热放散试验(P<0.05);新生儿溶血病患者治疗前、治疗后HCT水平差异无统计学意义(P>0.05);新生儿溶血病患者治疗后TB、RBC及Hb水平,均低于治疗前(P<0.05);新生儿溶血病患者治疗后T淋巴细胞水平得到明显改善,治疗后CD3+、CD4+、CD4+/CD8+,均高于治疗前(P<0.05);治疗后CD8+水平,低于治疗前(P<0.05);对于确诊的新生儿溶血病患儿均顺利完成治疗,治疗后黄疸消退时间(3.78±0.78)d、光疗时间(4.51±0.94)d及住院时间(8.11±1.04)d。结论不同放散试验用于新生儿溶血病中各有优缺点,但是三氯乙烯-三氯甲烷放散灵敏度较低,而冷冻复融放散可用于大批量样本;对于确诊患儿静脉注射免疫球蛋白治疗能改善患者症状,提高细胞免疫水平,治疗后加强冷冻复融放散检测能评估患者预后,指导临床治疗。
Objective:To investigate the detection effect of different release tests in neonatal hemolytic disease and its guiding value for clinical treatment prognosis. Methods:Seventy-five patients with neonatal hemolytic disease admitted from March 2015 to April 2018 were selected as subjects. The freeze-thaw dissolution,trichloroethylene-chloroform release and heat release tests were used to analyze and analyze three positive tests. Rate and positive degree;for the diagnosis of neonatal hemolytic disease patients combined with intravenous immunoglobulin therapy on the basis of conventional therapy,the effect of the patient was evaluated after 4 days of treatment;the total binding before and after treatment was measured by micro bilirubin monitor Bilirubin(TB)level;blood red blood cell count(RBC)was measured by blood cell counter;blood biochemical analyzer was used to measure hemoglobin(Hb)and hematocrit(HCT)levels before and 4 days after treatment;flow cytometry The patient′s CD3+,CD4+,CD4+/CD8+ levels were measured;the time of jaundice regression,phototherapy time and hospitalization time after treatment were counted and counted. Results:There was no significant difference in the positive rate and positive degree of frozen remelting and heat release test(P>0.05). The positive rate and positive degree of trichloroethylene-chloroform release test were lower than that of freeze-recombination and release. The heat release test(P<0.05);the difference of HCT level before and after treatment in neonatal hemolytic disease patients was not statistically significant(P>0.05);the levels of TB,RBC and Hb in neonatal hemolytic disease patients were lower than treatment. Before(P<0.05);the levels of T lymphocytes in neonatal hemolytic disease patients were significantly improved after treatment. CD3+,CD4+,CD4+/CD8+ were higher than those before treatment(P<0.05);CD8+ levels were lower after treatment. Before treatment(P<0.05);the children who were diagnosed with hemolytic disease were successfully treated. The time of jaundice subsided after treatment(3.78±0.78)d,phototherapy time(4.51±0.94)d and hospitalization time(8.11±1.04)d. Conclusion:Different release tests have advantages and disadvantages for neonatal hemolytic disease,but the sensitivity of trichloroethylene-chloroform release is low,while freeze-recombination release can be used for large-volume samples;intravenous immunoglobulin for confirmed children Treatment can improve the symptoms of patients and improve the level of cellular immunity. After treatment,the enhanced freeze-thaw release test can assess the prognosis of patients and guide clinical treatment.
作者
邱瑞萍
韩俊锋
吴雯雯
QIU Rui-ping;HAN Jun-feng;WU Wen-wen(Northwest Women and Children's Hospital,Xi'an Shanxi,710043)
出处
《中国优生与遗传杂志》
2019年第2期182-185,共4页
Chinese Journal of Birth Health & Heredity
关键词
新生儿溶血病
冷冻复融放散
三氯乙烯-三氯甲烷放散
热放散试验
预后
Neonatal hemolytic disease
Frozen recombination and release
Trichloroethylene-trichloromethane release
Heat release test
Prognosis
