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目的探讨婴幼儿溶血病血清学检验特点及相关因素。方法随机选取在医院分娩的疑似婴幼儿溶血病(HDN)患儿163例,收集患儿全血(乙二胺四乙酸抗凝)标本和临床资料,并进行血型鉴定以及直接抗人球蛋白实验。结果 163例患儿中,HDN阳性94例,占57.67%,其中ABO-HDN阳性93例占57.06%,Rh-HDN阳性1例占0.61%;随着母体孕期抗体效价的升高,HDN发生率呈逐渐上升趋势(P<0.05);患儿平均胆红素水平与抗体效价无相关关系(P>0.05);患儿A型血型HDN发生率明显高于B型血型,且随着标本采集时间的延长,HDN阳性率呈下降趋势(P<0.05)。结论婴幼儿溶血病检查中,放散试验灵敏度最高。随着母体血型抗体效价的升高,婴幼儿溶血发病率呈上升趋势,且A型血型更容易发生溶血。对疑似HDN婴幼儿,标本应尽早送检,提高检出率。
Objective To investigate the characteristics and related factors of serological test in hemolytic disease of infants and young children. Methods A total of 163 children with suspected hemolytic disease (HDN) were delivered at the hospital. Blood samples (EDTA) and clinical data were collected, and blood type identification and direct anti-human globulin test . Results Of the 163 children, HDN was positive in 94 cases (57.67%), of which 93 cases were ABO-HDN positive (57.06%) and Rh-HDN was positive (0.61%). HDN occurred with the increase of maternal antibody titer (P <0.05). There was no correlation between average bilirubin levels and antibody titer in children (P> 0.05). The incidence of type A HDN in children was significantly higher than that in type B, With the prolongation of collection time, the positive rate of HDN showed a decreasing trend (P <0.05). Conclusions Infant hemolytic disease tests showed the highest sensitivity to radiotherapy. With the increase of maternal blood group antibody titer, the incidence of hemolysis in infants and young children is on the rise, and type A blood group is more prone to hemolysis. The suspected HDN infants and young children, specimens should be submitted as soon as possible to improve the detection rate.