新生儿溶血病检测试验多样性与胆红素水平相关性研究(1)
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【摘要】 目的 探讨新生儿ABO溶血病(ABO HDN)溶血三项试验不同结果与胆红素水平的相关性。方法 对85例ABO HDN患儿进行血清溶血三项试验[抗人球蛋白试验(DAT)、游离抗体试验、抗体释放试验]、母亲IgG抗A(B)抗体、血清胆红素等测定。结果 ABO HDN患儿DAT阳性者血清总胆红素峰值与DAT阴性者比较,差异有统计学意义(P<0.05,0.01);DAT阴性间比较、DAT阳性间比较(P>0.05),差异无统计学意义。新生儿ABO HDN患儿母亲血型抗体与血清总胆红素水平比较,差异无统计学意义(P>0.05)。结论 ABO HDN患儿DAT阳性合并抗体释放试验阳性或三项试验均阳性时,血清胆红素水平增高较明显,DAT阴性释放试验和/或游离试验阳性时,新生儿ABO HDN相对较轻,而母亲IgG抗体效价高低不能反映HDN的严重程度,这可为临床合理治疗HDN提供帮助。
【关键词】新生儿溶血病; 抗人球蛋白试验;游离抗体试验,抗体释放试验;血清胆红素;IgG抗A(B)
Research on the relevance between different results of hemolysis detection tests and serum bilirubin levels of hemolytic disease of the newborn
SHI Chang hong,LI Cun yu,CAO Zong xin,et al.Department of Pediatrics,the center Hospital of Tengzhou,Tengzhou277500,China
【Abstract】 Objective To study the relevance between different results of three hemolysis detection tests and serum bilirubin levels of ABO hemolytic disease of the newborn(ABO HDN).Methods Serological hemolysis three tests(direct anti human globulin test,free antibody test,antibody release test),maternal anti A(B)IgG antibodies,serum bilirubin were examined in 85 cases of ABO HDN.Results There were significant differences in levels of total serum bilirubin(TSB)between groups of DAT positive and groups of DAT negative(P<0.05,or P<0.01).There weren’t significants difference between groups of DAT positive or groups of DAT negative in levels of total serum bilirubin(P>0.05).There wasn’t significant difference between maternal antibodies titer and levels of total serum bilirubin(P>0.05).Conclusion When DAT is positive,the serum bilirubin level was significantly increased,and maternal antibodies titer couldn’t show severity of ABO HDN.It could be helpfull for the clinical treatment of ABO HDN.
【Key words】ABO hemolytic disease of the newborn;direct anti human globulin test; Free antibody test; Antibody release test; Serum bilirubin;Anti A(B)IgG antibody
DOI:10.3760/cma.j.issn 1673 8799.2010.05.12
新生儿溶血病(HDN)特指由于母婴血型不合引起的同族免疫性溶血。母亲的血型抗体通过胎盘进入胎儿血液循环,引起胎儿或新生儿红细胞破坏。多种血型系统能够引起HDN,最常见的是ABO血型系统,其次为Rh血型系统,其他血型系统引起者偶见。该病仅发生在胎儿和新生儿早期可导致高胆红素血症,严重者易并发胆红素脑病,致新生儿死亡或遗留智力发育障碍、听力损害等。因此早期进行HDN的诊断,可以争取治疗时间,控制疾病的严重程度,提高治疗减少后遗症的发生 ......
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