呼气末一氧化碳测定对新生儿溶血病的诊断价值  

Diagnostic Value of End-tidal Carbon Monoxide in Hemolytic Disease of Newborn

作　　者：范礼英 冯彬彬[1] 李婷[1] 龚瑾[1] 李素萍[1] FAN Li-ying;FENG Bin-bin;LI Ting;GONG Jin;LI Su-ping(Department of Neonatology,Hunan Provincial Maternal and Child Care Hospital,Changsha 410000,Hunan,China)

机构地区：[1]湖南省妇幼保健院新生儿科,湖南长沙410000

出　　处：《医学信息》2023年第10期68-70,共3页Journal of Medical Information

基　　金：湖南省卫生健康委科研计划项目(编号:20200994)。

摘　　要：目的通过测定碳氧血红蛋白(COHb)和呼气末一氧化碳(ETCOc)水平,早期识别处于溶血性高胆红素血症风险的新生儿。方法回顾性分析2021年5月-9月本院新生儿科收治的新生儿高胆红素血症(黄疸值Bhutani95%以上)60例作为研究对象,根据溶血全套结果分为溶血组(36例)与非溶血组(24例)。两组均在采血后1 h内进行ETCOc检测。分析患儿一般情况、ETCOc、COHb、血红蛋白(HB)、网织红细胞(Ret)及总胆红素值(STB)。结果36例患儿确诊ABO溶血病、24例患儿为非溶血性高胆红素血症,两组STB比较,差异无统计学意义(P>0.05);溶血组Ret高于非溶血组,Hb低于非溶血组,但差异无统计学意义(P>0.05);溶血组COHb、ETCOc值高于非溶血组,差异有统计学意义(P<0.05);COHb、ETCO的AUC分别为61.10%、74.30%(P<0.05),ETCOc最佳截断值为2.15 ppm。结论与Ret、Hb溶血指标相比,ETCOc测定可作为新生儿溶血病早期筛查指标。Objective To identify neonates at risk of hemolytic hyperbilirubinemia by measuring the levels of carboxy-hemoglobin(COHb)and end-tidal carbon monoxide(ETCOc).Methods A retrospective analysis of 60 cases of neonatal hyperbilirubinemia(jaundice value Bhutani 95%or more)admitted to the neonatal department of our hospital from May to September 2021 was conducted.According to the results of hemolysis,they were divided into hemolysis group(36 cases)and non-hemolysis group(24 cases).ETCOc detection was performed within 1 h after blood collection in both groups.The general condition,ETCOc,COHb,hemoglobin(HB),reticulocyte(Ret)and total bilirubin(STB)were analyzed.Results Of 36 children were diagnosed with ABO hemolytic disease and 24 children were diagnosed with non-hemolytic hyperbilirubinemia.There was no significant difference in STB between the two groups(P>0.05).Ret in hemolytic group was higher than that in non-hemolytic group,and Hb was lower than that in non-hemolytic group,but the difference was not statistically significant(P>0.05).The values of COHb and ETCOc in the hemolytic group were higher than those in the non-hemolytic group(P<0.05).The AUC of COHb and ETCO were 61.10%and 74.30%,respectively(P<0.05),and the optimal cutoff value of ETCOc was 2.15 ppm.Conclusion Compared with Ret and Hb hemolysis indexes,ETCOc determination can be used as an early screening index for neonatal hemolytic disease.

关 键 词：内源性一氧化碳 呼气末一氧化碳含量 新生儿溶血病 

分 类 号：R722.18[医药卫生—儿科]