【摘要】 目的探讨溶血三项联合血清总胆红素检测对新生儿溶血病(HDN)早期诊断的临床价值。方法选取2019年3月至2020年5月上饶市人民医院接收的100例HDN患儿,均给予溶血三项(直抗试验、游离试验、释放试验)联合血清总胆红素检测,根据溶血三项检测结果将患儿分为A、B、C、D 4组。其中,A组为直抗试验(+)、游离试验(-)、释放试验(+),B组为直抗试验(+)、游离试验(+)、释放试验(+),C组为直抗试验(-)、游离试验(-)、释放试验(+),D组为直抗试验(-)、游离试验(+)、释放试验(+),比较溶血三项联合血清总胆红素检测和溶血三项单独检测对HDN的早期诊断情况,并对所有患儿进行丙种球蛋白静脉注射及蓝光光疗等治疗,比较4组治疗前、后的血清总胆红素水平。结果联合检测对HDN的早期检出率(97%)高于溶血三项单独检测(85%),差异有统计学意义(P<0.05);4组治疗后的血清总胆红素水平均低于治疗前,差异有统计学意义(P<0.05)。结论溶血三项联合血清总胆红素检测能够显著提升HDN的早期检出率。更多还原

【Abstract】 Objective The clinical value of serum total bilirubin combined with three hemolytic tests in the early diagnosis of hemolytic disease of newborn(HDN) was explored. Methods 100 children with HDN received by Shangrao People’s Hospital From March 2019 to May 2020 were selected in this study. Three hemolytic tests(direct anti human globulin test, free antibody test and antibody release test) in combination with the test of serum total bilirubin were given to the selected children. According to the results of three hemolytic tests, the children were divided into four groups. The results of Group A were direct anti human globulin test(+), free antibody test(-) and antibody release test(+). The results of Group B were direct anti human globulin test(+), free antibody test(+) and antibody release test(+). The results of Group C were direct anti human globulin test(-), free antibody test(-) and antibody release test(+). The results of Group D were direct anti human globulin test(-), free antibody test(+) and antibody release test(+). The early diagnostic condition of serum total bilirubin combined with three hemolytic tests and single three hemolytic tests for HDN were compared. All the children were treated with intravenous injection of gamma globulin and blue light phototherapy. The serum total bilirubin levels of the four groups before and after treatment were compared. Results The early detection rate of HDN by serum total bilirubin combined with three hemolytic tests(97%) was higher than that by single three hemolytic tests(85%), and the difference was statistically significant(P<0.05); The serum total bilirubin levels of the four groups after treatment were all lower than those before treatment, and the differences were statistically significant(P<0.05). Conclusion The early detection rate of HDN could be improved by serum total bilirubin combined with three hemolytic tests.更多还原