CAJ | 학술논문

目的：通过分析新生儿ABO溶血病血清学实验室检测的结果，了解不同检测时间段患儿阳性率的差异；血清学三项试验阳性率的差异；不同母婴血型组合阳性率的差异。方法对223例临床怀疑为新生儿ABO溶血病患儿的标本根据不同检测时间段分为4组，分别为出生1d组、2d组、3d组、＞3d组；根据母婴血型组合分为O‐A组合和O‐B组合。各组均进行血型鉴定及改良直接抗人球蛋白试验、抗体游离试验、抗体热放散试验，并比较各组检测结果。结果新生儿ABO溶血病实验室检测：出生1 d组阳性率为89．8％，2 d组阳性率为90．9％，3 d组阳性率为87．0％，＞3d组阳性率为76．7％，出生1～3d阳性率较集中，且随着时间的延长，阳性率呈下降趋势。O‐A组阳性率88．6％，O‐B组阳性率77．1％，O‐A组阳性率明显高于O‐B组。结论血清学三项试验中抗体热放散试验的阳性率高于改良直接抗人球蛋白试验及抗体游离试验，放散试验是“三项试验”中判定ABO‐HDN最有力的证据。
목적：통과분석신생인ABO용혈병혈청학실험실검측적결과，료해불동검측시간단환인양성솔적차이；혈청학삼항시험양성솔적차이；불동모영혈형조합양성솔적차이。방법대223례림상부의위신생인ABO용혈병환인적표본근거불동검측시간단분위4조，분별위출생1d조、2d조、3d조、＞3d조；근거모영혈형조합분위O‐A조합화O‐B조합。각조균진행혈형감정급개량직접항인구단백시험、항체유리시험、항체열방산시험，병비교각조검측결과。결과신생인ABO용혈병실험실검측：출생1 d조양성솔위89．8％，2 d조양성솔위90．9％，3 d조양성솔위87．0％，＞3d조양성솔위76．7％，출생1～3d양성솔교집중，차수착시간적연장，양성솔정하강추세。O‐A조양성솔88．6％，O‐B조양성솔77．1％，O‐A조양성솔명현고우O‐B조。결론혈청학삼항시험중항체열방산시험적양성솔고우개량직접항인구단백시험급항체유리시험，방산시험시“삼항시험”중판정ABO‐HDN최유력적증거。
Objective To understand the difference of neonatal positive rates among different detection peri‐ods ,difference of positive rates in serological 3 items tests and difference of positive rates among different combina‐tions of maternal and neonatal blood groups by analyzing the laboratory detection results in ABO hemolytic disease of newborn(ABO‐HDN) .Methods The samples from 223 cases of clinically suspected ABO‐HDN were divided into 4 groups of birth 1 ,2 ,3 ,>3 d according to different detection periods and the O‐A combination group and O‐B combi‐nation group according to maternal and neonatal blood type .The various groups were performed the blood type iden‐tification ,improved direct antiglobulin testing (DAT ) ,antibody free test and antibody thermal radiation test .The de‐tection results were compared among various groups .Results In the results of ABO‐HDN laboratory detection :the positive rates in the birth 1 ,2 ,3 ,> 3 d groups were 89 .8% ,90 .9% ,87 .0% and 76 .7% respectively ,the positive rates were relatively concentrated on birth 1-3 d ,moreover with the extension of time ,the positive rate showed the decreasing trend ;the positive rates in the O‐A group and the O‐B group were 88 .6% and 77 .1% respectively ,the positive rate in the O‐A group was obviously higher than that in the O‐B group .Conclusion The positive rate in the thermal radiation test is higher than that in the improved DAT and antibody free test .The elution test is the most powerful evidence for judging ABO‐HDN .