不同胎龄与出生体质量新生儿经皮胆红素和血清胆红素的相关性研究

摘要

目的 探讨不同胎龄与出生体质量新生儿经皮胆红素(TcB)和血清胆红素(TsB)的相关性.方法 选择广东省东莞市第五人民医院2011年12月至2013年8月收治的黄疸新生儿160例,目测出现黄疸后48 h内均未经蓝光治疗,按胎龄分为28～ 30周组(10例),＞30 ～ 34周组(15例),＞34～37周组(77例),＞ 37～ 42周组(58例);按出生体质量分为750 ～1 500 g组(12例),＞1 500 ～2 000 g组(32例),＞2 000～2 500 g组(48例),＞2 500～4 000 g组(68例).分别于目测发现皮肤黄疸时和其后24、48 h各检测TcB和TsB 1次,共检测3次,比较各时点TcB和TsB的差异以及相关性.结果 新生儿出现目测黄染时和其后24h,TcB均明显低于TsB[(88 ±31) μmol/L比(105±28) μmol/L,(118±30) μmol/L比(125±30) μmol/L],差异有统计学意义(P＜0.01),但其后48 h,TcB和TsB值比较[(139±30) μmol/L比(142±27) μmol/L],差异无统计学意义(P＞0.05).＞30～ 34周组、＞34 ～ 37周组、＞37～42周组新生儿各时点TcB与TsB均呈明显正相关(均P＜0.01),但28 ～ 30周组新生儿TcB与TsB无明显相关性(P＞0.05).不同出生体质量新生儿各时点TcB与TsB均呈正相关(均P＜0.05).结论 未经蓝光治疗的新生儿目测出现黄疸时及其后24 h TcB值低于TsB,其后48 h二者差异消失;＞30周胎龄和不同出生体质量新生儿TcB与TsB呈正相关.%Objective To explore the correlation of transcutaneous bilirubin (TcB) and total serum bilirubin (TsB) in neonates with different gestational age and birth weight.Methods Totally 160 neonates with jaundice who did not received blue light therapy within 48 h from December 2011 to August 2013 were enrolled.According to the gestational age, the neonates were divided into 28-30 weeks group (10 cases), ＞ 30-34 weeks group (15 cases), ＞34-37 weeks group (77 cases), ＞ 37-42 weeks group (58 cases);according to the birth weight, the neonates were divided into 750-1 500 g group (12 cases), ＞ 1 500-2 000 g group (32 cases), ＞2 000-2 500 g group (48 cases) , ＞2 500-4 000 g group (68 cases).The TcB and TsB were measured at appearance of visible jaundice and 24, 48 later.The correlation of TcB and TsB were analyzed.Results The TcB was significantly lower than TsB at appearance of visible jaundice and 24 hours later [(88 ± 31) μmol/L vs (105 ± 28) μmol/L, (118 ± 30) μmol/L vs (125 ± 30) μmol/L] (P ＜ 0.01), while were not significantly different 48 hours later [(139 ±30) μmol/L vs (142 ±27) μmol/L] (P ＞0.05).TcB and TsB were positively correlated in ＞30-34 weeks group, ＞34-37 weeks group and ＞37-42 weeks group (P ＜0.01), but not significantly correlated in 28-30 weeks group (P ＞ 0.05);TcB and TsB were positively correlated in all birth weight groups (all P ＜ 0.05).Conclusions The TcB is lower than TsB when and 24 h after appearance of visible jaundice, then the difference disappeared 48 h later;TcB and TsB are correlated in neonates with gestational age ＞ 30 weeks and in all meonates with different birth weight.