论文部分内容阅读
目的:结合脐血胆红素浓度测定和经皮测胆红素早期预测和诊断新生儿高胆红素血症(高胆)。方法:采集408例足月新生儿脐静脉血检测总胆红素浓度,用经皮胆红素测定仪动态监测生后3天内新生儿的TCB值,与其后发生高胆红素血症的患儿进行对比分析。结果:新生儿高胆组的脐血总胆红素平均浓度为41.61μmol/L。高胆发生率随脐血总胆红素浓度的增加而升高,当浓度≤50μmol/L时高胆阳性预测值均较低,≥50.1μmol/L时高胆发生率最高(62.07%),其阳性预测值(62.07%)、阴性预测值(81%)和特异度(96.54%)均优于其他各组,但其敏感度仅为20%。高胆组TCB日均值在生后24 h、48 h、72 h分别为13.65、17.19、19.54,TCB日均差值72~24 h(3~1天)、72~48 h(3~2天)、48~24 h TCB(2~1天)分别为5.98、2.5、3.52,均高于非高胆组(P<0.01)。结论:脐血总胆红素浓度测定可早期预测高胆的发生,但敏感度低,结合动态监测TCB有助于早期诊断和早期干预高胆。
OBJECTIVE: To combine the determination of cord blood bilirubin concentration and percutaneous bilirubin for the early prediction and diagnosis of neonatal hyperbilirubinemia (hypercholesterolemia). Methods: 408 cases of full-term neonatal umbilical venous blood test for total bilirubin concentration, the use of transcutaneous bilirubin analyzer dynamic monitoring of newborn within 3 days after birth, the TCB value, and subsequent hyperbilirubinemia Children for comparative analysis. Results: The average concentration of total bilirubin in neonatal hypercholesterolaemia group was 41.61μmol / L. The incidence of hypercholesterolemia increased with the increase of umbilical blood total bilirubin concentration. When the concentration was less than 50μmol / L, the predictive value of high gallbladder was low, and the highest rate of hypercholesterolemia was 62.07% when ≥50.1μmol / The positive predictive value (62.07%), negative predictive value (81%) and specificity (96.54%) were better than other groups, but the sensitivity was only 20%. The average daily mean value of TCB in high gall group was 13.65,17.19,19.54 at 24 hrs, 48 hrs and 72 hrs after birth, and average daily TCB was 72-24 h (3-1 days), 72-48 h (3-2 days) ), TCB (48 days to 24 hours) were 5.98,2.5,3.52 respectively, which were higher than those in non-hyperbiliary group (P <0.01). Conclusion: The determination of total bilirubin concentration in umbilical cord blood can predict the occurrence of hypercholesteremia in early stage, but the sensitivity is low. Combined with the dynamic monitoring of TCB, it is helpful for the early diagnosis and early gallbladder hypercholesterolemia.