新生儿脑脊液胆红素在胆红素脑病诊断中的研究  

The Research of Bilirubin Levels in Neonatal Cerebrospinal Fluid in the Diagnosis of Bilirubin Encephalopathy

作　　者：孙路璐[1] 金玉莲[1] 刘光辉[1] 张健[1] 郑洪[1] 

机构地区：[1]安徽医科大学儿科临床学院新生儿科,合肥市230051

出　　处：《中华全科医学》2013年第8期1181-1183,共3页Chinese Journal of General Practice

摘　　要：目的探讨高胆红素血症新生儿脑脊液未结合胆红素水平对胆红素脑病的早期诊断价值。方法以2011年2月-2012年10月入院的34例胆红素脑病患儿(病例组)和37例单纯高胆红素血症患儿(对照组)为研究对象,比较两组脑脊液及血清未结合胆红素水平,并绘制ROC曲线,计算脑脊液未结合胆红素及血清未结合胆红素水平在诊断胆红素脑病中的临界值、灵敏度、特异度、阳性预测值和阴性预测值。结果胆红素脑病组患儿脑脊液未结合胆红素(13.88±5.03)μmol/L明显高于对照组(5.83±4.30)μmol/L,差异具有统计学意义(P<0.01)。通过绘制ROC曲线,得出脑脊液未结合胆红素的ROC曲线下面积(0.909)大于血清未结合胆红素的ROC曲线下面积(0.692)。当临界值为9.55μmol/L时,脑脊液未结合胆红素诊断胆红素脑病的灵敏度为86.7%,特异度为93.9%。结论新生儿脑脊液未结合胆红素水平可作为早期诊断胆红素脑病的敏感指标,早期对高胆红素血症患儿进行脑脊液胆红素水平检测,将有利于胆红素脑病的早期诊断和及时治疗,减少胆红素脑病后遗症的发生。Objective To investigate the value of concentration of bilirubin in cerebrospinal fluid for early diagnosis of neonatal bilirubin encephalopathy.Methods 34 cases with bilirubin encephalopathy and 37 cases with non-bilirubin encephalopathy as control group were chosen from February 2011 to October 2012.The concentrations of unconjugated bilirubin in cerebrospinal fluid and unconjugated bilirubin in serum of two groups were compared.According to the ROC curve,their critical value,sensitivity,specificity,positive predictive value and negative predictive value in the diagnosis of bilirubin encephalopathy were analyzed.Results The unconjugated bilirubin in cerebrospinal fluid in the bilirubin encephalopathy group（13.88 ± 5.03） μmol /L was significant higher than that in the control group（5.83 ± 4.30） μmol / L（P〈0.01）,there was statistical significance in difference（P〈0.01）.The area under curve of unconjugated bilirubin in cerebrospinal fluid（0.909） was larger than that of unconjugated bilirubin in serum（0.692）,according to the ROC curve.When the critical value was 9.55 μmol / L,the sensitivity and specificity of unconjugated bilirubin in cerebrospinal fluid in the diagnosis of neonatal bilirubin encephalopathy were 86.7% and 93.9%,respectively.Conclusion Unconjugated bilirubin in cerebros-pinal fluid value was a good indicator for predicting bilirubin encephalopathy and it was helpful to provide information for rational clinical treatment of hyperbilirubinemia.

关 键 词：新生儿 脑脊液 胆红素 胆红素脑病 

分 类 号：R722.19[医药卫生—儿科] R446.141[医药卫生—临床医学]