沈美萍，陈士华

(平湖市第一人民医院，浙江 平湖 314200)

脐带血标本用于检测新生儿溶血三项的临床价值

沈美萍，陈士华

(平湖市第一人民医院，浙江 平湖 314200)

目的：分析新生儿脐带血与静脉血对其溶血病(HDN)检测结果有无差异。方法对O型孕妇(丈夫非O型)进行产前IgG溶血性抗体效价的测定，对效价≥1∶128的孕妇，在分娩时留取新生儿脐带血，同时采集出生后1～2天和3～4天、5～7天静脉血，进行新生儿溶血三项(直接抗人球蛋白试验、游离抗体试验和放散试验)检测并比较。结果同一患儿脐带血与出生后1～2天采集静脉血检测结果无差异，与出生后3～4天、5～7天采集的静脉血检测结果差异有统计学意义。结论脐带血和静脉血虽均可作为新生儿溶血病的检测，但脐带血阳性率高，而且取材方便，便于早诊断早治疗，可作为诊断HDN的首选标本。

新生儿溶血病；溶血三项试验；脐带血；静脉血；IgG抗体效价

Abstract： [Objective] To analyze the differences of umbilical cord blood and veinal blood in testing neonatal hemolysis. [Method] Prenatal determination of IgG antibody titer was tested in pregnant women with O-type blood (husband with non-O). For pregnant women with titer ≥1∶128, newborn cord blood specimens were collected in childbirth, meanwhile veinal blood were collected 1-2 days, 3 - 4 days, 5-7 days after born. The direct antiglobin test、indirect antiglobulin test and elution test were carried out to detect neonatal hemolysis with above blood specimens. [Result] There are no difference between cord blood and veinal blood that collected 1-2 days after born.There are significant difference between cord blood and veinal blood that collected 3-4 days or 5-7 days after born. [Conclusion] Although umbilical cord blood and venous blood can be used as the specimens for detection of hemolytic disease of the newborn, cord blood had higher positive rate and drawing convenience, ease of early diagnosis and treatment. It can be used as the preferred diagnostic specimens.

Keywords: hemolytic disease of newborn; hemolytic three test; umbilical cord blood; venous blood; IgG antibody titer

新生儿溶血病(Hemolytic Disease of Newborn，HDN)一般特指母婴血型不合，母体内的IgG溶血性抗体通过胎盘进入胎儿及新生儿血液循环，引起胎儿及新生儿红细胞破坏的被动免疫性溶血性疾病[1]。HDN主要包括ABO血型系统和RH系统不合的溶血，在我国以ABO溶血病为主[2]。近年来在新生儿溶血病防治方面的进展已使该病的严重性和预后有了明显改善，但它仍是新生儿期黄疸和贫血的重要原因。本文探究新生儿脐带血与静脉血对溶血三项(直接抗人球蛋白、游离抗体、放散试验)结果的异同，以寻找一种准确、方便、快速的标本来检测新生儿溶血病。……