经皮测量总胆红素在新生儿高胆红素血症评估中的应用价值

目的探讨经皮测量胆红素浓度对新生儿黄疸检测的准确性和实用性。方法对400例高胆红素血症新生儿同时进行了经皮测量总胆红素和血清总胆红素的检测,分析两者的相关性,并评估体质量、胎龄、生后日龄、相关病因等对新生儿胆红素水平的影响。结果血清总胆红素<257μmol/L时,经皮测量总胆红素与血清总胆红素值的相关系数是0.932,血清总胆红素≥257μmol/L时,相关系数是0.282,两组均呈正相关性,血清总胆红素<257μmol/L组相关性高(P=0.0001),且不受胎龄、体质量、生后日龄及相关病因的影响。结论当胆红素浓度<257μmol/L,经皮测量总胆红素可以替代血清总胆红素;经皮测量总胆红素用于新生儿高胆的筛查,有可推广性及实用性。

The value of transcutaneous bilirubin measurement in the management of neonatal hyperbilirubinemia

Objective To investigate accuracy and practicality of the transcutaneous bilirubin(TCB)measurement in neonatal bilirubinemia assessment.Methods Four hundred concomitant assays were performed(transcutaneous or in plasma),and the correlation and level of agreement between them were calculated.An assessment was also performed to study the influence of birth weight,gestational age and postnatal age.Results The mild jaundice were 200 cases,moderate and severe jaundice were 200 cases.The linear correlation coefficient was 0.932(P = 0.0001)in cases with total serum bilirubin(TSB)< 257 μmol/L.The linear correlation coefficient was 0.282(P = 0.004)in cases with TSB ≥ 257 μmol/L.Calculation showed a high correlation between TCB and TSB.No influence of birth weight,gestational age and postnatal age was observed on total bilirubin.Conclusions TSB assay can be substituted by TCB assay when total bilirubin is less than 257 μmol/L.TCB can be extended and practical in the management of neonatal hyperbilirubinemia.