新生儿高未结合胆红素血症光照疗法量效关系分析  

Phototherapy of Unconjugated Hyperbilirubinemia in Newborns: Dose-Effect Relationships

作　　者：钱建青 凌万里 周剑峰[1] 顾梅青[1] 

机构地区：[1]江苏省常熟市中医院,江苏常熟215500

出　　处：《儿科药学杂志》2014年第5期10-12,共3页Journal of Pediatric Pharmacy

摘　　要：目的：对比分析足月新生儿及早产儿高胆红素血症蓝光治疗的量效关系。方法：用单面光疗装置治疗112例足月儿及69例早产儿高胆红素血症,测定其治疗前后微量血胆红素指数及血清胆红素（TSB）浓度,每3 h检测暴露部位及非暴露部位经皮胆红素指数（TCB）。分别按日龄≤7 d和〉7 d及是否早产分组进行统计分析。足月儿≤7 d组为A组,〉7 d为B组;早产儿≤7 d组为C组,〉7 d为D组。结果：（1）经连续光疗24 h,四组非暴露部位TCB下降值分别为（55.58±37.28）μmol/L、（70.97±35.74）μmol/L、（32.83±38.82）μmol/L、（51.47±37.96）μmol/L,与同组暴露部位TCB下降幅度比较差异有统计学意义（t=8.32、9.12、6.57、7.48,P均〈0.01）;（2）光疗24 h期间暴露部位及非暴露部位TCB指数下降速率不同,暴露部位及非暴露部位TCB差值在早产儿≤7 d组光疗12 h后达最大值,其余三组光疗9 h后达最大值,之后变化不明显（t=0.82、0.78、0.91、1.05,P均〉0.05）,停止光疗后TCB差值缩小,暴露部位TCB值接近非暴露部位TCB值所需时间早产儿≤7 d组为6 h,其余三组为9 h。结论：不论足月儿或早产儿,光疗对高未结合胆红素血症疗效确切,不同组别可采用不同间隔时间进行间歇光照疗法,建议早产儿≤7 d组以单次单面光疗时间12~15 h,停光疗时间12~9 h为宜,其余三组以光疗时间9~12 h,停光疗时间15~12 h为宜。Objective： To explore the dose-effect relationship of phototherapy in the treatment of hyperbilirubinemia in full-term and premature infants. Methods： Blood bilirubin index and serum bilirubin （TSB） concentrations of 112 full-term infants and 69 premature infants with hyperbilirubinemia were measured before and after phototherapy; transcutaneous bilirubin indexes （TCB） at exposed parts and non-exposed parts were also measured every 3 hours. Patients were divided into A （ full-term infants ≤ 7 days）, B （ full-term infants 〉 7 days）, C （premature infants ≤ 7 days） and D （premature infants 〉 7 days）four groups based on daily age ≤ 7 days and 〉 7 days, and clinical data were statistically analyzed. Results ： （ 1 ） After 24 hours＇ continuous phototherapy, the decreases of TCB at non-exposed parts in the four groups were （55.58 ± 37.28 ） μmol/L, （70.97 ± 35.74 ） μmol/L, （32.83 ± 38.82 ） μmol/L and （51.47±37.96） μmol./L, respectively. The difference of TCB decrease between exposed parts and non-exposed parts within the same group was significant （t = 8.32, 9.12, 6.57, 7.48, P〈0.01 ）. （2） During 24 hours＇ phototherapy TCB index of non-exposed parts and exposed parts decreased at different rates. The D value of TCB at non-exposed parts and exposed parts reached the maximum in preterm infants ≤7 days group after 12 hours＇ phototherapy, and in other three groups after 9 hours＇ phototherapy. After 12 hours＇ phototherapy the difference was not obvious （t =0.82, 0.78, O. 91, 1.05, P〉0.05 ）. The D value of TCB decreased after stopping phototherapy. TCB value of exposed parts was close to that of non-exposed parts. The required time for preterm infants ≤7 days group was 6 hours, while other groups were 9 hours. Conclusions： Phototherapy has curative effect on unconjugated hyperbilirubinemia in full-term and premature infants. Patients with different ages should receive intermittem phototherapy with different interval. It is sugg

关 键 词：高胆红素血症 新生儿 光照疗法 量效关系 

分 类 号：R722.17[医药卫生—儿科]