CAJ | 학술논문

目的：探讨联合检测溶血三项试验（直接抗人球蛋白试验、游离抗体测定和抗体放散试验）和血清总胆红素对新生儿溶血病（ HDN）的早期诊治价值。方法采用微柱凝胶卡式法检测212例黄疸新生儿静脉血（母亲血型均为O型）溶血三项试验，根据试验阳性率将溶血三项试验阳性的患儿分为下列四组：1组：直抗试验（＋）、游离试验（＋）、释放试验（＋）；2组：直抗试验（＋）、游离试验（-）、释放试验（＋）；3组：直抗试验（-）、游离试验（＋）、释放试验（＋）；4组：直抗试验（-）、游离试验（-）、释放试验（＋）。统计各组构成比，使用全自动生化分析仪测定各组的血清总胆红素水平并比较。结果直接抗人球蛋白试验、游离抗体试验及抗体释放试验阳性率分别为18．4％（39/212）、33．5％（71/212）、39．6％（84/212），游离试验阳性率和抗体释放试验阳性率差异无统计学意义（χ2＝1．70，P＞0．05），与直抗试验阳性率差异均有统计学意义（χ2＝23．18，12．58，均P＜0．05）。四组患儿血清总胆红素水平均有显著升高，但组间差异均无统计学意义（F＝1．369，P＞0．05）。结论溶血三项试验和血清总胆红素联合检测作为HDN的早期诊断和分析病情的依据，有助于及早控制新生儿溶血升高，降低并发症和后遗症的出现。
목적：탐토연합검측용혈삼항시험（직접항인구단백시험、유리항체측정화항체방산시험）화혈청총담홍소대신생인용혈병（ HDN）적조기진치개치。방법채용미주응효잡식법검측212례황달신생인정맥혈（모친혈형균위O형）용혈삼항시험，근거시험양성솔장용혈삼항시험양성적환인분위하렬사조：1조：직항시험（＋）、유리시험（＋）、석방시험（＋）；2조：직항시험（＋）、유리시험（-）、석방시험（＋）；3조：직항시험（-）、유리시험（＋）、석방시험（＋）；4조：직항시험（-）、유리시험（-）、석방시험（＋）。통계각조구성비，사용전자동생화분석의측정각조적혈청총담홍소수평병비교。결과직접항인구단백시험、유리항체시험급항체석방시험양성솔분별위18．4％（39/212）、33．5％（71/212）、39．6％（84/212），유리시험양성솔화항체석방시험양성솔차이무통계학의의（χ2＝1．70，P＞0．05），여직항시험양성솔차이균유통계학의의（χ2＝23．18，12．58，균P＜0．05）。사조환인혈청총담홍소수평균유현저승고，단조간차이균무통계학의의（F＝1．369，P＞0．05）。결론용혈삼항시험화혈청총담홍소연합검측작위HDN적조기진단화분석병정적의거，유조우급조공제신생인용혈승고，강저병발증화후유증적출현。
Objective To explore the early diagnostic and treatment value of combined detection of direct antiglobulin test ,free antibody and antibody releasing test ( hemolysis three tests ) and measurement of serum total bili-rubin for hemolytic disease of newborn ( HDN) .Methods Hemolysis three tests were carried out with micro column gel technology in 212 blood samples from neonatal jaundice ( derived from the O type mothers ) and positive rate differ-ences in hemolysis three tests were compared .Patients were divided into 4 groups by the antibody results in hemolysis three tests:group 1[direct antiglobulin test ( +),free antibody test ( +) and antibody releasing test ( +)],group 2[(direct antiglobulin test(+),free antibody test(-) and antibody releasing test(+)],group 3[direct antiglobu-lin test(-),free antibody test(+) and antibody releasing test(+),and group 4[direct antiglobulin test( -),free antibody test (-) and antibody releasing test (+) ] .Constituent ratio was compared .The total bilirubin in serum from four groups were determined by automatic biochemical analyzer and compared .Results The positive rates of direct antiglobulin test,free antibody test and antibody release test were 18.4%(39/212),33.5%(71/212) and 39.6%(84/212) respectively.The positive rate had no significant difference between antibody release test and free antibody test(χ2 =1.70,P>0.05),but compared with direct antiglobulin test ,the differences were significant (χ2 =23.18, 12.58,all P<0.05).Serum total bilirubin levels in four groups were significantly increased ,but had no significant differences(F=1.369,P>0.05).Conclusion Combined detection of serum total bilirubin and serum hemolysis three tests can be used as the early diagnosis and patients condition of HDN ,and contribute to the early control of neo-natal hemolytic increase ,reduce complications and sequelae .