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L评分对新生儿ABO溶血病的诊断潜力:一项横断面研究的见解

The Diagnostic Potential of the L Score for ABO Hemolytic Disease of the Newborn: Insights from a Cross-Sectional Study.

作者信息

Li Yike, Deng Jun

机构信息

Department of Clinical Laboratory, Changsha Hospital for Maternal and Child Health Care Affiliated to Hunan Normal University, Changsha, 410007 Hunan China.

Department of Clinical Laboratory, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, 410004 Hunan China.

出版信息

Indian J Hematol Blood Transfus. 2024 Jul;40(3):469-478. doi: 10.1007/s12288-023-01723-5. Epub 2024 Jan 5.

Abstract

PURPOSE

This study aimed to evaluate the diagnostic efficacy of the L score, a novel scoring system, in distinguishing between ABO hemolytic disease of the newborn (ABO-HDN) and non-hemolytic disease of newborn hyperbilirubinemia (NHDNH).

METHODS

A cross-sectional prospective study was conducted to assess the effectiveness of the L score in distinguishing between ABO-HDN ( = 118) and NHDNH ( = 213). Blood routine examination results were collected, and relevant statistical analyses were performed to identify clinically significant parameters. Binary logistic regression analysis was employed to assess the relationship between the L score and the development of these conditions, considering relevant variables.

RESULTS

Our study identified the red blood cell count, mean corpuscular volume, red blood cell distribution width-coefficient of variation, and red blood cell distribution width-standard deviation as independent risk factors for distinguishing ABO-HDN from other high bilirubinemia conditions ( < 0.001). The L score demonstrated superior predictive performance for ABO-HDN, exhibiting an area under the curve (AUC) of 0.746, with an optimal cutoff value of - 3.0816. The RBC-L score exhibited superior predictive performance (z: 5.596,  < 0.0001) compared to the single-factor RBC indicator, indicating its efficacy in accurately identifying the desired outcome.

CONCLUSION

The L score represents a valuable tool for predicting neonatal hyperbilirubinemia and hemolytic disease, facilitating differentiation, and guiding early intervention for improved outcomes. Further research is warranted to validate and expand the applicability of the L score in clinical practice.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12288-023-01723-5.

摘要

目的

本研究旨在评估一种新型评分系统——L评分在区分新生儿ABO溶血病(ABO-HDN)和新生儿非溶血性高胆红素血症(NHDNH)方面的诊断效能。

方法

进行了一项横断面前瞻性研究,以评估L评分在区分ABO-HDN(n = 118)和NHDNH(n = 213)方面的有效性。收集血常规检查结果,并进行相关统计分析以确定具有临床意义的参数。采用二元逻辑回归分析,考虑相关变量,评估L评分与这些疾病发生之间的关系。

结果

我们的研究确定红细胞计数、平均红细胞体积、红细胞分布宽度变异系数和红细胞分布宽度标准差是区分ABO-HDN与其他高胆红素血症情况的独立危险因素(P < 0.001)。L评分对ABO-HDN表现出卓越的预测性能,曲线下面积(AUC)为0.746,最佳截断值为 - 3.0816。与单因素红细胞指标相比,红细胞-L评分表现出卓越的预测性能(z:5.596,P < 0.0001),表明其在准确识别预期结果方面的效能。

结论

L评分是预测新生儿高胆红素血症和溶血病、促进鉴别诊断以及指导早期干预以改善结局的有价值工具。有必要进行进一步研究以验证并扩大L评分在临床实践中的适用性。

补充信息

在线版本包含可在10.1007/s12288-023-01723-5获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e9/11246374/ecdf7532ac94/12288_2023_1723_Fig1_HTML.jpg

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