脐血胆红素水平对ABO溶血足月新生儿黄疸的预测效果  

The prediction effect of cord blood bilirubin levels on ABO hemolytic term neonatal jaundice

作　　者：邸菁华[1] 海冬[1] 陈瑞珊[1] 乔艳秋[1] 王彩芳[1] 

机构地区：[1]开滦总医院儿科,河北唐山063000

出　　处：《西部医学》2016年第5期678-680,683,共4页Medical Journal of West China

基　　金：河北省科技厅攻关项目(20132761361)

摘　　要：目的探究脐血胆红素水平对ABO溶血足月新生儿黄疸的预测效果。方法选择2013年1月-2015年1月在我院出生的ABO溶血足月新生儿88例。研究不同脐血胆红素水平的ABO溶血足月新生儿黄疸的发生率、治疗率,分析其预测能力,比较黄疸新生儿和非黄疸新生儿的脐血总胆红素浓度、脐血间接胆红素浓度和脐血直接胆红素浓度。结果随脐血胆红素水平的升高,ABO溶血足月新生儿黄疸的发生率也随之升高,脐血胆红素水平〉60μmol/L的新生儿黄疸的发生率高达80.00%。随脐血胆红素水平的升高,ABO溶血足月新生儿黄疸进展到需要治疗地步的比例也随之升高,脐血胆红素水平〉60μmol/L的新生儿黄疸需要治疗的概率为100.00%。脐血胆红素水平对ABO溶血足月新生儿黄疸的预测能力总体较好,其中脐血胆红素水平在0-30μmol/L和〉60μmol/L的阳性预测值和特异性高达100%。黄疸新生儿的脐血总胆红素浓度和脐血间接胆红素浓度明显高于非黄疸新生儿,差异有统计学意义（P〈0.05）,两组新生儿的脐血直接胆红素浓度比较,差异无统计学意义（P〉0.05）。结论脐血胆红素水平可作为预测ABO溶血病足月儿发生黄疸的有效指标,具有一定的临床实用价值。Objective To explore the umbilical cord blood bilirubin level prediction effect of ABO hemolytic fullterm neonatal jaundice.Methods 88 ABO hemolytic term newborn infants born in our hospital from January 2013 to January 2015 were involved in the present study.The incidence of neonatal jaundice in term neonates with different levels of serum bilirubin,and the predictive power of ABO,and the concentrations of total bilirubin,indirect bilirubin and direct bilirubin concentration of umbilical cord blood were observed.Results With the increase of serum bilirubin level,the incidence of jaundice in term neonates with ABO was also increased,and the incidence rate of neonatal jaundice with umbilical cord blood bilirubin level of 60mol/L was as high as 80%.With the increase of serum bilirubin level,the proportion of ABO hemolytic term neonatal jaundice to the point of treatment was also increased.The rate of umbilical cord blood bilirubin level〉60mol/L neonatal jaundice needing treat was 100%.The serum bilirubin level of ABO hemolytic term neonatal jaundice prediction ability was generally good.The umbilical cord blood bilirubin levels in 0-30mol/L and 60mol/L positive predictive value and specificity was up to 100%.The concentrations of total bilirubin and indirect bilirubin were significantly higher than those of non jaundice neonates,and the difference was statistically significant（P〈0.05）,and there was no significant difference between the two groups（P〉0.05）.Conclusion Umbilical cord blood bilirubin levels as a predictor of ABO hemolytic disease of the full-term infants jaundice index has certain practical value.

关 键 词：脐血胆红素 ABO溶血 新生儿黄疸 预测效果 

分 类 号：R722.17[医药卫生—儿科]