摘要
目的 探讨孕期血型鉴定与溶血三项检测在新生儿溶血病(HDN)早期诊断中的应用价值.方法 选择 2022 年 1 月—2023 年 12 月在徐州矿务集团总医院进行产前检查并分娩的 2 136 例产妇作为研究对象,鉴定其ABO血型及Rh(D)血型.对有黄疸症状的新生儿检查ABO血型、Rh(D)血型及溶血三项实验(直接抗人球蛋白实验、血清游离抗体试验、抗体释放试验).结果 659 例疑似HDN患儿中有135 例最终确诊,检出率为 20.5%.其中男性 55 例(占 40.7%),女性 80 例(占 59.3%),差异有统计学意义(P<0.05).135 例HDN患儿中有 126 例(占 93.3%)由ABO血型系统引起,8 例(占 5.9%)由Rh血型系统(抗-D、抗-E、抗-Ec、抗-c)引起,1 例(0.7%)由MNS系统(抗-M)引起.ABO-HDN患儿中女性患儿占比显著高于男性患儿(61.9%比 38.1%),差异有统计学意义(P<0.05).溶血三项中血清游离抗体试验和抗体释放试验均为阳性的检出率最高,为 54.8%.结论 孕期产检血型鉴定与溶血三项检查有利于早期发现HDN的发生风险,针对孕妇血型为O型的情况应尽早明确胎儿及新生儿血型,若血型不合则需给予密切关注,并及时进行干预治疗.
Abstract
Objective To explore the application value of blood group identification and hemolytic three items detection in the early diagnosis of hemolytic disease of newborn(HDN).Methods The 2 136 pregnant women undergoing prenatal examination and delivery at Xuzhou Mining Group General Hospital from January 2022 to December 2023 were selected as research subjects,and their ABO and Rh(D)blood groups were identified.ABO blood group,Rh(D)blood group and hemolytic three items detection(direct antiglobulin test,serum free antibody test,antibody release test)were performed on newborns with jaundice symptoms.Results Among the 659 suspected HDN newborns,135 cases were finally diagnosed,with a detectable rate of 20.5%.Among them,55 cases(40.7%)were male and 80 cases(59.3%)were female,with a significant difference(P<0.05).Among the 135 newborns with HDN,126 cases(93.3%)were caused by ABO blood group system,8 cases(5.9%)by Rh blood group system(anti-D,anti-E,anti-Ec,anti-c),and 1 case(0.7%)by MNS system(anti-M).The proportion of female with ABO-HDN was higher than that of male(61.9%vs.38.1%),with a significant difference(P<0.05).The positive detectable rate of both serum free antibody test and antibody release test was the highest at 54.8%.Conclusions Blood group identification and hemolytic three items detection during pregnancy are beneficial for early detection of the risk of HDN.For mothers of type O,it is important to identify the blood group of fetus as early as possible.For pregnant women with blood type O,the blood type of the fetus and newborn should be determined as soon as possible.If the blood type is incompatibility,close attention should be paid and timely intervention treatment should be given.
基金项目
江苏省徐州市卫生健康委青年医学科技创新项目(XWKYHT20210527)
维普
万方数据