新生儿溶血病阳性检出率的差异分析

    Variance analysis of the positive detection rate of hemolytic disease

    • 摘要: 目的:探讨不同日龄、母婴不同血型组合及直抗、游离、放散“三项试验”新生儿溶血病(HDN)阳性检出率的差异。方法:采用微柱凝胶法检测技术对母婴进行ABO及Rh(D)血型鉴定,患儿直抗、游离、放散试验,母亲Rh(D)阴性做不规则抗体检测,然后对不同日龄、母婴不同血型组合及“三项试验”的阳性率进行分析统计。结果:418例胆红素升高患儿确诊为HDN的有186例,总阳性率44.50%;其中患儿≤ 3 d组125例(49.21%),> 3~7 d组38例(39.18%)、> 7 d组23例(34.33%),3组HDN阳性率差异有统计学意义(P<0.05);母婴O-A组95例(66.90%)、O-B组91例(57.96%),2组HDN发病率差异无统计学意义(P>0.05);直抗、游离、放散阳性率分别为7.66%、31.82%和44.50%。结论:HDN以ABO-HDN为主,患儿≤ 3 d检出率最高,放散试验阳性率最高,为诊断直接依据。

       

      Abstract: Objective:To investigate the differences of the positive detection rate between different day-age,different blood group of mother-baby,and "direct antiglobulin test,indirect antiglobulin test and dilution test" of child in hemolytic disease of the newborn(HDN).Methods:The ABO and Rh(D) blood groups in mother-baby were identified using the micro-column gel agglutination assay.The direct antiglobulin test,indirect antiglobulin test and dilution test in children,and the irregular antibody in mother with negative Rh(D) were examined.The positive rates of the different day-age,blood group of mother-baby and "three tests" in detecting the hemolysis were analyzed.Results:Among 418 neonates with high bilirubin,186 cases were diagnosed as HDN,the total positive rate of which was 44.50%.Among 186 HDN children,the neonates ≤ 3 days old in 125 cases(49.21%),neonates > 3 days and ≤ 7 days in 38 cases(39.18%),and neonates > 7 days in 23 cases(34.33%) were identified,the difference of which was statistically significant(P<0.05).The blood group of mother-baby as O-A in 95 cases(66.90%) and O-B in 91 cases(57.96%) were found,the difference of which was not statistically significant(P>0.05).The positive rates of the direct antiglobulin test,indirect antiglobulin test and dilution test were 7.66%,31.82% and 44.50%,respectively.Conclusions:The most common type of HDN is ABO-HDN,the detection rate of neonates ≤ 3 days old is the highest,and the positive rate of dilution test is highest,which can be used as the directly diagnostic basis of HDN.

       

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