Abstract：Objective To explore the value of detecting serum total bilirubin in umbilical cord blood in the early diagnosis and treatment of hemolytic disease of newborns (HDN) so as to provide references for its early screening, diagnosis and therapy. Methods A total of 482 neonates with maternal-fetal ABO incompatibilitywere selected as the research objectsin Taizhou Hospital of Zhejiang Province from March, 2013 to February, 2016. Serological hemolysis three tests (direct antiglobulin test (DAT), antibody release test (ART) and free antibody test (FAT)) were performed, and the serum total bilirubin level was detected by automatic biochemical analyzer.We analyzedthe correlation between the serum total bilirubin level and the results of the three different hemolysis tests, mother’s blood type, time of occurrence of jaundice. Results The incidence rate of ABO-HDN in the 482 neonates was 31.95%, of which the maternal and neonatal types of O-O, O-A and O-B accounted for 22.08%, 46.75% and 31.17% respectively. 77 neonates suffered from hyperbilirubinemia. The incidence rate of HDN, bilirubin level in umbilical cord blood, positive rates of antibody release test and free antibody test in the maternal and neonatal O-A/B blood group were significantly higher than those in the maternal and neonatal O-O blood group (all P<0.05). No statistically significant differences were found in the incidence rate of HDN and bilirubin level in umbilical cord blood between the maternal and neonatal O-A blood group and the maternal and neonatal O-B blood group (both P>0.05). The positive rates of antibody release test and free antibody test in the maternal and neonatal O-A blood group were both significantly higher thanthose ofthe maternal and neonatal O-B blood group (χ2=5.265, P=0.021; χ2=9.075, P=0.000). The total bilirubin in umbilical cord blood was significantly higher in the age group of ≤ 3 days than in the age group of > 3 days. The serum total bilirubin level was significantly higher in DAT-positive patients than in DAT-negative patients (P<0.05). No statistically significant difference was found in the serum total bilirubin level among DAT-positive patients as well as among DAT-negative patients (both P>0.05). There was no statistically significant difference betweem FAT-positive patients and FAT-negative patients. The higher the level of bilirubin in umbilical cord blood, the higher the incidence of hyperbilirubinemia (r=0.741, P<0.05). Conclusions Serum total bilirubin detection in umbilical cord blood and serological hemolysis three tests in newborns with ABO incompatibility play important roles in the early diagnosis and treatment of ABO-HDN.
方声,黄邀,卢洪萍,范海玲,周露丹. 脐带血血清总胆红素检测在新生儿溶血病早期诊治中的应用价值[J]. 实用预防医学, 2017, 24(4): 491-494.
FANG Sheng, HUANG Yao, LU Hong-ping, FAN Hai-ling, ZHOU Lu-dan. Application value of detection of serum total bilirubin in umbilical cord blood in the early diagnosis and treatment of hemolytic disease of newborns. , 2017, 24(4): 491-494.
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2017, Vol. 24 
