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目的:回顾分析血型血清学诊断78例疑似新生儿溶血病的患儿资料,系统阐明溶血三项试验的临床意义,为临床诊断新生儿溶血病提供有效依据。方法:随机选取2011年1月-2013年12月贵阳医学院附属医院收治的疑似新生儿溶血病的78例患儿资料,采用微柱凝胶免疫检测法,鉴定患儿ABO、Rh血型及溶血三项试验,并对疑似ABO以外新生儿溶血病用母亲血筛查不规则抗体。结果:在78例新生儿溶血病疑似病例中,共有52例确诊为新生儿溶血病患儿,总阳性率约为66.67%,其中新生儿ABO溶血49例,,所占比例为94.23%,新生儿RH(D)溶血3例,所占比例为5.77%。O-A型26例(50%),O-B型23例(44.23%)。经数据分析,O-A型与O-B型新生儿溶血病发病率对比,差异均无统计学意义(P>0.05)。直接抗人球蛋白试验阳性率32.69%(17/52),血清游离抗体试验阳性率59.62%(31/52),抗体释放试验阳性率94.23%(49/52)。血液采集时间为0~6 d和超过6 d疑似新生儿溶血病患儿,检测结果阳性率分别为72.06%和30.00%。两组新生儿溶血病患儿阳性率比较,差异具有统计学意义(P<0.05),且血液采集时间为0~6 d组检测阳性率明显高于采集时间超过6 d组。结论:结合患儿临床表现,并采用溶血3项检测对有效诊断新生儿溶血病具有重要的临床意义。
OBJECTIVE: To retrospectively analyze the data of 78 cases of suspected hemolytic disease of neonates with blood group serodiagnosis, systematically clarify the clinical significance of the three trials of hemolysis and provide an effective basis for clinical diagnosis of hemolytic disease of newborn. Methods: A total of 78 children with suspected hemolytic disease of neonates admitted to the Affiliated Hospital of Guiyang Medical College from January 2011 to December 2013 were selected. The micro-column gel immunoassay was used to identify the blood type and hemolytic Three trials, and screening of irregular antibodies for mothers with suspected hemolytic disease outside ABO. Results: Of the 78 suspected cases of hemolytic disease of newborn, 52 cases were diagnosed as neonatal hemolytic disease with a total positive rate of 66.67%. Among them, 49 cases were newborn with ABO hemolysis, accounting for 94.23% Pediatric RH (D) hemolysis in 3 cases, the proportion was 5.77%. 26 cases (50%) were type O-A and 23 (44.23%) were type O-B. The data analysis, O-A type and O-B type hemolytic disease incidence of neonatal contrast, the difference was not statistically significant (P> 0.05). The positive rate of direct anti-human globulin test was 32.69% (17/52), the positive rate of serum free antibody test was 59.62% (31/52), and the positive rate of antibody release test was 94.23% (49/52). Blood collection time was 0 ~ 6 d and more than 6 d suspected hemolytic disease in neonates, the positive rate of test results were 72.06% and 30.00%. The positive rate of hemolytic disease between the two groups, the difference was statistically significant (P <0.05), and the blood collection time was 0 ~ 6 d group positive rate was significantly higher than the acquisition time of more than 6 d group. Conclusion: Combined with the clinical manifestations of children, and the use of three hemolysis test for the effective diagnosis of neonatal hemolytic disease has important clinical significance.