摘要
目的研究碳氧血红蛋白在新生儿ABO溶血病中的诊断价值。方法将患者分为三组,选取144例足月新生儿ABO溶血病患儿为溶血组(A组),选取同期160例不合并溶血的足月黄疸新生儿为非溶血性黄疸组(B组),同时与88例足月健康新生儿(C组)对比。分析三组间碳氧血红蛋白、总胆红素、红细胞计数等有无差异。结果溶血组患儿的碳氧血红蛋白水平较健康新生儿高,两组间差异有统计学意义(P<0.001)。同时,溶血组患儿的碳氧血红蛋白水平较非溶血性黄疸组患儿高,两组间差异有统计学意义(P<0.001)。碳氧血红蛋白在非溶血性黄疸组和健康新生儿组无统计学差异。碳氧血红蛋白ROC曲线值为1.27%时诊断新生儿ABO溶血病的敏感度和特异度最高(分别为90%和70%,P<0.001)。溶血组患儿总胆红素水平与碳氧血红蛋白呈正相关关系(r=0.83523,P<0.001),非溶血性黄疸患儿总胆红素水平与碳氧血红蛋白无相关性(r=0.12571,P>0.05),溶血组患儿组总胆红素水平低于非溶血性黄疸患儿,而碳氧血红蛋白水平高于非溶血性黄疸患儿(P<0.001)。结论碳氧血红蛋白对新生儿ABO溶血病的诊断有临床意义,同时碳氧血红蛋白检测可作为体内胆红素产生量的指标,其有助于黄疸病因的鉴别、诊断及治疗。
Objective To explore clinical significance of determination of carboxyhemoglobin in ABO hemolytic disease of the newborn.Methods A total of 392 cases were randomly selected in the study.The experiment consisted of three groups:a total of 144 newborns consecutively hospitalized with ABO hemolysis were treated as experimental group(Group A);160 newborns with hyperbilirubinemia and without hemolysis were collected(Group B);and 88 healthy newborns at term were the control group(Group C).Carboxyhemoglobin,serum total bilirubin and hemoglobin was collected and were compared with in the three subgroups.Results Compared with group C,carboxyhemoglobin were higher in ABO hemolytic disease(P<0.001).Compared with group B,carboxyhemoglobin were higher in ABO hemolytic disease(P<0.001),while carboxyhemoglobin showed no significant difference between group B and C(P>0.05).A carboxyhemoglobin cut-off value of 1.27%had 90%sensitivity and 70%specificity for predicting prescription.There was a positive correlation between total bilirubin level and carboxyhemoglobin level in newborns with ABO hemolysis(r=0.83523,P<0.001).Conclusion Carboxyhemoglobin indicates the procedure of ABO hemolytic disease of the newborn,which is helpful to diagnose the cause of hyperbilirubinemia and taken as a guide in therapy.
作者
田亚慧
于凤琴
TIAN Yahui;YU Fengqin(Zhengzhou Maternity Hospital Affiliated to Henan University,Zhengzhou 450000,China)
出处
《广州医药》
2020年第2期54-57,共4页
Guangzhou Medical Journal
基金
河南省医学科技攻关计划项目(2018020713)。
关键词
新生儿ABO溶血病
黄疸
碳氧血红蛋白
诊断
ABO hemolytic disease of newborn
Hyperbilirubinemia
Carboxyhemoglobin
Diagnosis
