摘要
目的 研究脐血血清溶血三项及胆红素在早期诊断新生儿高胆红素血症中的价值.方法 选取1 200例健康新生儿,其母亲为O型血,父亲非O型血,根据母婴血型情况,分为母婴血型相同组539例,母婴血型不同组661例;根据脐血胆红素浓度范围分成五组,分析脐血胆红素及脐血溶血三项预测新生儿发生高胆红素血症的价值.结果 （1）母婴血型不同组脐血血清胆红素浓度、新生儿ABO溶血病（ABO-HDN）的发生率及新生儿高胆红素血症发生率分别为（38.1±10.3） μmol/L、47.35％、26.02％,均显著高于母婴血型相同组的（33.4±7.9） μmol/L、15.21％、14.66％（t=5.8,Х^2=120.7、20.1,均P=0.000）;（2）新生儿高胆红素血症的发生率随着脐血胆红素浓度的升高而增加,但敏感度及特异性均差;（3）联合脐血胆红素,根据溶血三项结果来预测新生儿高胆红素血症的发生率,在脐血胆红素浓度＜21 μmol/L或≥55.1 μmol/L时,特异性和阳性预测值均为100.00％,敏感性分别为75.00％、86.96％.结论 联合分析脐血血清胆红素及溶血三项结果,可早期预测母婴ABO血型不合所致的新生儿高胆红素血症的发生,临床上具有一定的实用价值.
Objective To study the application value of serum umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Methods 1 200 cases of healthy newborn were selected,whose mothers were type O blood and fathers were not type O blood.According to the situation of maternal and infant blood type,they were divided into the same maternal and child blood type group with 539 cases and different blood type group with 661 cases;According to the umbilical cord blood bilirubin concentration range was divided into five groups,and analyzed umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Results （1） The concentrations of umbilical cord blood bilirubin,the incidence of ABO-HDN,the incidence of hyperbilirubinemia in the maternal-fetal blood（O-A/B） group were （38.1 ± 10.3） μmol/L,47.35%,26.02%,respectively,which were all significantly higher than （33.4 ± 7.9）μmol/L,15.21%,14.66% in the maternal blood type （O-O） group （t =5.8,Х^2 =120.7,Х^2 =20.1,all P =0.000） ; （2） When the concentrations of umbilical cord blood bilirubin was higher,the incidence of hyperbilirubinemia was higher,but the sensitivity and the specificity both were bad; （3） According to the result of hemolysis three to predict the neonatal hyperbilirubinemia,when the concentrations of umbilical cord blood bilirubin was less than 21μmol/L or more than 55μmol/L,the positive predictive value and the specificity both were 100.00%,and the sensitivity was not low（75.00% and 86.96%）.Conclusion Detection of umbilical cord blood bilirubin and hemolysis three test in the maternal-fetal blood group incompatibility could predict early hyperbilirubinemia of newborn,which had certain clinically practical value.
出处
《中国基层医药》
CAS
2015年第1期57-59,共3页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省广州市花都区科技计划项目（HD11-Y041）
关键词
高胆红素血症
溶血
胎血
Hyperbilirubinemia
Hemolysis
Fetal Blood
