经皮胆红素检测在新生儿溶血性黄疸中的研究  

Clinical study of transcutaneous bilirubin measurement in monitoring neonatal hemolytic jaundice

作　　者：杨文青[1,2] 詹玉[1] 聂睿 姚斌[1] 王建辉[2] 余加林[2] 

机构地区：[1]四川省医学科学院/四川省人民医院儿科,成都610072 [2]重庆医科大学附属儿童医院新生儿治疗中心,400014

出　　处：《检验医学与临床》2017年第8期1063-1064,共2页Laboratory Medicine and Clinic

基　　金：重庆市卫生和计划生育委员会医学科研项目(2015MSXM039)

摘　　要：目的在新生儿溶血性黄疸动态监测过程中,对比经皮胆红素(TcB)值和血液胆红素(TsB)值,为临床通过新生儿TcB值评估黄疸治疗效果提供理论依据。方法选取2015年1-10月在四川省人民医院儿科住院诊断为新生儿ABO血型不合性溶血病62例作为研究对象,对所有住院新生儿在入院时、光疗8~10h后及光疗48h后分别进行TcB检测。在TcB检测的同时抽取静脉血进行TsB检测。结果入院时、光疗8~10h后及光疗48h后的TcB值与TsB值均有显著相关性(r=0.886、0.717、0.867,P<0.05),其中入院时和光疗48h后的TcB值与TsB值相关性最好;对TcB值与TsB值进行t检验发现,入院时和光疗48h后的TcB值与TsB值之间比较差异无统计学意义(t=0.256,P=0.799;t=1.6,P=0.115),而光疗8~10h后的TcB值与TsB值之间差异有统计学意义(t=7.201,P<0.05)。结论光疗前与光疗48h后的TcB值与TsB值之间具有较好的一致性,而光疗8~10h后的TcB值与TsB值则存在较大差异,此时的TcB值不能准确反映实际的胆红素水平。Objective To contrast the values of transcutaneous bilirubin（TcB） measurement and total serum bilirubin（TsB） in dynamic monitoring process of neonatal hemolytic jaundice to provide a theoretic basis for evaluating the jaundice treatment effect by the neonatal TcB value in clinic. Methods Sixty-two neonatal inpatients with ABO-incompatible hemolytic disease in our hospi- tal from January to October 2015 were taken as the research subjects. TcB in all subjects was detected at admission, at 8--10 h and 48 h after phototherapy. The venous blood was simultaneous collected for detecting TsB. Results The TsB value at admission,8- 10 h and 48 h after phototherapy was significantly correlated with the TcB value（r=0. 886,0.717,0. 867, P〈 0.05） 9 in which the best correlation was found the TcB value and TsB value at admission and 48 h after phototherapy. Meanwhile, there was no statisti- cal difference between the TsB value and TcB value at admission and 48 h after phototherapy（t= 0. 256, P=0. 799;t=1.6, P= 0. 115）, there was statistical difference between TsB and TcB at 8--10 h after phototherapy（t = 7.201, P% 0.05）. Conclusion The TsB value and TcB value before phototherapy and at 48 h after phototherapy have good consistency, while which at 8--10 h after phototherapy have greater difference,the TcB value at this moment can not accurately reflect the practical level of bilirubin.

关 键 词：黄疸 血液胆红素 经皮胆红素 新生儿 

分 类 号：R722[医药卫生—儿科]