新生儿溶血三项及孕妇血清抗体效价检测在新生儿溶血病诊断中的应用价值

目的探讨新生儿溶血三项、孕妇血清抗体效价检测在新生儿溶血病(HDN)诊断中的应用价值。方法收集西安凤城医院2017年1月至2018年3月203例孕妇为O型Rh阳性血型、新生儿为A(B)型Rh阳性血型的样本,分别进行新生儿血型检测、直接抗人球蛋白试验、血清游离抗体试验、红细胞释放试验检测以及孕妇血清抗体效价检测。结果203例新生儿中,A型血106例(52.22%),B型血97例(47.78%);证实为ABO-HDN者为128例(63.05%),不能证实为ABO-HDN者75例(36.95%);203例孕妇中,1∶64效价占89例(43.84%),1∶128效价占59例(29.06%),1∶256效价占26例(12.81%),1∶512效价占18例(8.87%),>1∶512效价占11例(5.42%);除1∶64抗体效价外,孕妇血清IgG抗A(B)抗体的效价越高,ABO-HDN的发生率越高。结论新生儿溶血三项试验、孕妇血清抗体效价检测在ABO-HDN诊断方面具有一定的临床价值。

Application value of detection of three items of hemolysis in newborn and serum antibody titers in pregnant women in diagnosis of hemolytic disease of the newborn

Objective To explore the application value of detection of three items of hemolysis in newborn and serum antibody titers in pregnant women in diagnosis of hemolytic disease of the newborn (HDN). Methods Samples of 203 pregnant women with Rh positive blood type O and neonates with Rh positive blood type A(B) from Xi'an Fengcheng Hospital from January 2017 to March 2018 were collected. Neonatal blood group test, direct anti-human globulin test, serum free antibody test, erythrocyte release test and serum antibody titer test of pregnant women were performed respectively. Results Among 203 neonates, there were 106 cases (52.22%) with type A blood and 97 cases (47.78%) with type B blood;there were 128 cases (63.05%) were confirmed as ABO-HDN, 75 cases (36.95%) could not be confirmed as ABO-HDN. Among 203 pregnant women, 1∶64 titer accounted for 89 cases (43.84%), 1∶128 titer accounted for 59 cases (29.06%), 1∶256 titer accounted for 26 cases (12.81%), 1∶512 titer accounted for 18 cases (8.87%) and >1∶512 titer accounted for 11 cases (5.42%). Except for the titer of 1∶64 antibody, the higher the titer of IgG anti-A(B) antibody in serum of pregnant women, the higher the incidence of ABO-HDN. Conclusion Three items of hemolysis in newborn and serum antibody titers in pregnant women have certain clinical value in the diagnosis of ABO-HDN.