[1]黄道连,蔡凤娟,童辉纯,等.外周血涂片球形红细胞计数在新生儿ABO溶血病中的诊断价值[J].现代检验医学杂志,2018,33(01):63-66.[doi:10.3969/j.issn.1671-7414.2018.01.001]
　HUANG Dao-lian,CAI Feng-juan,TONG Hui-chun,et al.Diagnostic Value of Peripheral Blood Smear Spherical Erythrocyte Count in ABO-Hemolytic Disease of the Newborn[J].Journal of Modern Laboratory Medicine,2018,33(01):63-66.[doi:10.3969/j.issn.1671-7414.2018.01.001]
点击复制

外周血涂片球形红细胞计数在新生儿ABO溶血病中的诊断价值()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年01期
页码:
63-66
栏目:
论著
出版日期:
2018-02-05

文章信息/Info

Title:
Diagnostic Value of Peripheral Blood Smear Spherical Erythrocyte Count in ABO-Hemolytic Disease of the Newborn
文章编号:
1671-7414(2018)01-063-04
作者:
黄道连; 蔡凤娟; 童辉纯; 邓坤仪; 李丽莲; 刘 继; 翁小玲
南方医科大学附属中山市博爱医院检验科,广东中山 528400
Author(s):
HUANG Dao-lian; CAI Feng-juan; TONG Hui-chun; DENG Kun-yi; LI Li-lian; LIU Ji;  WENG Xiao-ling
Department of Medical Laboratory,Zhongshan Boai Hospital Affilited to Southern Medical University,Guangdong Zhongshan 528400,China
关键词:
新生儿ABO溶血病;  外周血涂片;  球形红细胞计数;  诊断价值
分类号:
R722.18; R446.111
DOI:
10.3969/j.issn.1671-7414.2018.01.001
文献标志码:
A
摘要:
目的 探讨新生儿外周血涂片球形红细胞计数对新生儿ABO溶血病(BO-HDN)诊断的临床价值。方法 回顾性分析中山市博爱医院2009～2015年165例临床诊断为新生儿ABO溶血病数据结果作为实验组; 以68例非ABO溶血病新生儿数据结果为对照组,调查其相关临床资料和实验室检测指标,并比对分析其溶血三项试验结果。结果 165例新生儿ABO溶血病中球形红细胞阳性为110例,阳性率为66.7%(χ2=58.069,P<0.05),其中出生日龄≤2天,3～4天和≥5天的球形红细胞阳性率分别为68.8%,60.5%和66.7%; 球形红细胞对新生儿ABO溶血病的诊断灵敏度为66.7%,特异度为88.2%,阳性预测值为93.2%,阴性预测值为52.2%; 当球形红细胞计数阳性界点为≥5%时,诊断ABO-HDN的灵敏度为66.7%,特异度为88.2%; 若设置球形红细胞阳性界点为≥10%,则诊断ABO-HDN的灵敏度降低到9.3%,但是特异度达到98.5%; ABO-HDN组外周血与非ABO-HDN组比较,有核红细胞、RDW和Ret水平较高,血红蛋白水平较低,差异均有统计学意义(均P<0.05)。结论 外周血涂片球形红细胞计数对ABO-HDN诊断的灵敏度和特异度较高,联合黄疸、贫血和RDW等指标可为ABO-HDN的早期诊断、预防和治疗提供指导。
Abstract:
Abstract:Objective To evaluate the clinical value of neonatal peripheral blood smear spherical erythrocyte count in the diagnosis of ABO-HDN.Methods 165 cases clinically diagnosed with ABO-HDN in Zhongshan Boai Hospital from 2009 to 2015 were listed as the experimentalgroup by retrospective analysis,68 cases of non-ABO-HDN were listed as control group.Besides,relevant clinical data and experimental examination were investigated,and the results of their hemolysis test were analysed.Results Peripheral blood smear spherical erythrocyte count were positivein 110 cases of 165 patients with ABO-HDN,the positive rate of spherical erythrocytes was 66.7%(χ2=58.069,P<0.05).The spherical erythrocyte positive rates were 68.8%,60.5% and 66.7% in patients aged ≤2d,3～4d,≥5d respectively.The diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7%,the specificity was 88.2%,the positive predictive value was 93.2%,andnegative predictive value was 52.2%.When spherical erythrocyte count positivepoint was set as ≥5% spherical erythrocytes,the diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7% and the specificity was 88.2%.If the positive point was set as ≥10% spherical erythrocytes,the sensitivity of ABO-HDN decreases to 9.3%,and the specificity reaches 98.5%.In ABO-HDN group,the levels of nucleated red blood cell,RDW and Ret were higher,along with the lower level of hemoglobin compared with non-ABO-HDN group(all P<0.05).Conclusion The peripheral blood smear spherical erythrocyte count had a high sensitivity and specificity for the diagnosis of ABO-HDN.Combined with jaundice,anemia and RDW,peripheral blood smear spherical erythrocyte count can provide guidance for the early diagnosis,prevention and treatment of ABO-HDN.

参考文献/References:

[1] 邓家栋.临床血液学[M].上海:科学技术出版社,1985:451-453. Deng JD.Clinical hematology[M].Shanghai:Science and TechnologyPress,1985:451-453.
[2] 洪 毅.不规则抗体致新生儿溶血病换血治疗的研究分析[J].现代检验医学杂志,2016,31(6):135-137. Hong Y.Analysis of irregular antibodies induced by treatment of neonatal hemolysis[J].Journal of Modern Laboratory Medicine,2016,31(6):135-137.
[3] 林朝霞,董清松.新生儿ABO溶血病的检测与分析[J].中国实验血液学杂志,2014,22(5):1432-1434. Lin ZX,Dong QS.Detection and analysis of ABO hemolytic disease innewborn[J].Journal of Experimental Hematology,2014,22(5):1432-1434.
[4] Santavy J.Hemolytic disease in the newborn-history and prevention in the world and the Czech Republic[J].Biomed Pap Med Fac Univ Palacky Olomouc,Czech Repub,2010,154(2):147-151.
[5] 田兆嵩,何子毅,刘仁强.临床输血质量管理指南[M].北京:科学出版社,2011:275-277. Tian ZS,He ZY,Liu RQ.Guidelines for quality management of clinical blood transfusion[M].Beijing:Science Press,2011:275-277.
[6] 耿 波,梁 锋,夏国新,等.降钙素原C反应蛋白心肌酶联合检测在新生儿高胆红素血症诊断中的价值[J].国际检验医学杂志,2014,35(18):2441-2443. Geng B,Liang F,Xia GX,et al.Clinical significance of procalcitonin,C-reactive protein and myocardial enzymes determination in patients with neonatal hyperbilirubinemia[J].International Journal of Laboratory Medicine,2014,35(18):2441-2443.
[7] 马晓露.孕母血型抗体与新生儿ABO溶血病发生的相关性分析[J].中国实验诊断学,2009,13(12):1744-1746. Ma XL.Relationship between ABO hemolytic disease of newborn and maternal antibody[J].Chinese Journal of Laboratory Diagnosis,2009,13(12):1744-1746.
[8] 尚 红,王毓三,申子瑜.全国临床检验操作规程[S].4版.北京:人民卫生出版社,2015:123-124. Shang H,Wang YS,Shen ZY.National guide to clinical laboratoryprocedures[S].4th Ed.Beijing:People's Publishing Press,2015:123-124.
[9] 李保才,黎海澜,周雪勤,等.O型孕妇IgG抗体效价与新生儿溶血病发病关系调查分析[J].齐齐哈尔医学院学报,2013,34(12):1806-1807. Li BC,Li HL,Zhou XQ,et al.Analysis of the relationship between O-type pregnant women IgG titer and neonatal hemolytic disease[J].Journal ofQiqihar University of Medicine,2013,34(12):1806-1807.
[10] 刘孟黎,张 艳,刘 晟,等.新生儿溶血病患儿母亲血清中IgG亚型水平的临床意义[J].细胞与分子免疫学杂志,2006,22(4):498-499. Liu ML,Zhang Y,Liu S,et al.Clinical significance of serum IgG subtypein maternal serum of neonates with hemolytic disease of the newborn[J].Chinese Journal of Cellular and Molecular Immunology,2006,22(4):498-499.
[11] 张静华,张慧芳,吴绍梅.ABO新生儿溶血病与O型母亲免疫性抗体效价的相关性分析[J].放射免疫学杂志,2012,25(2):237-238. Zhang JH,Zhang HF,Wu SM.Analysis of correlation between hemolytic disease of newborn with ABO and immune titer of O-type mothers[J].Journal of Radioimmunology,2012,25(2):237-238.
[12] 朱建锋,潘柏申.血片红细胞形态学检查在疾病诊断中的应用[J].检验医学与临床,2013,10(23):3211-3212. Zhu JF,Pan BS.Application of blood red blood cell morphology in the diagnosis of disease[J].Laboratory Medicine and Clinical,2013,10(23):3211-3212.
[13] 黄道连,袁春雷,陈健锋,等.自主编写检验形态学系列挂图在临床检验教学中的应用价值评价[J].现代检验医学杂志,2013,28(5):151-154. Huang DL,Yuan CL,Chen JF,et al.Application and evaluation of self-compiled laboratory's wall charts about cellular morphology in clinical laboratoryteaching[J].Journal of Modern Laboratory Medicine,2013,28(5):151-154.
[14] 杨 丽,阎丽华,丁 伟,等.新生儿ABO血型不合溶血病临床及实验室结果分析研究[J].现代检验医学杂志,2015,30(4):158-160. Yang L,Yan LH,Ding W.Clinical and experimental analysis about ABO hemolytic disease of the newborn in Qingdao[J].Journal of Modern Laboratory Medicine,2015,30(4):158-160.
[15] 吴少云,余占娟,吕 豪.51例ABO新生儿溶血病血清学试验结果的分析[J].临床血液学杂志(输血与检验),2017(3):471-472. Wu SY,Yu ZJ,L(¨overu)H.Analysis of hematologic test results in 51 cases of ABO hemolytic disease of the newborn[J].Journal of Clinical Hematology(Blood Transfusion and Laboratory Medicine),2017(3):471-472.
[16] 贾金平,汪 莎,王 沛,等.脐带血在ABO新生儿溶血病早期诊断的研究[J].中国妇幼保健,2013,28(36):5977-5979. Jia JP,Wang S,Wang P,et al.Experimental study of umbilical cord bloodin the early diagnosis of ABO hemolytic disease of the newborn[J].Maternal and Child Health Care of China,2013,28(36):5977-5979. 收稿日期:2017-09-30 修回日期:2017-11-22

相似文献/References:

[1]屈柯暄,周丽华,王淑霞,等.新生儿ABO溶血病微柱凝集法放散试验中放散液剂量优化研究[J].现代检验医学杂志,2019,34(03):121.[doi:10.3969/j.issn.1671-7414.2019.03.030]
　QU Ke-xuan,ZHOU Li-hua,WANG Shu-xia,et al.Study on Different Doses of Diffuser in Serological Testof ABO-Hemolytic Disease of Newborns[J].Journal of Modern Laboratory Medicine,2019,34(01):121.[doi:10.3969/j.issn.1671-7414.2019.03.030]

备注/Memo

备注/Memo:
基金项目:广东省中山市医学科研基金项目(2013A020031)。 作者简介:黄道连(1961-),男,中专,主任技师,主要从事血液形态学研究,E-mail:13702528623@139.com。
更新日期/Last Update: 2018-02-07