Tiberi E, Latella C, Parenti D, Romagnoli C
Unità Operativa di Neonatologia, Ospedale Cristo Re, Roma, Italy.
Minerva Pediatr. 2007 Jun;59(3):183-9.
The aim of this paper was to assess the ability of total serum bilirubin (TSB) levels in the first 3 days of life to predict subsequent nonphysiologic hyperbilirubinemia.
The predictive ability of an hour-specific nomogram for TSB values in the first week of life was prospectively assessed in 1496 full term neonates admitted to a first level neonatal unit, using a single TSB value or two consecutive ones, when available.
The incidence of TSB values > 12 mg/dL was 9.6%, while the incidence of TSB > 15 mg/dL was 2.6%. A sensitivity of 97.9% and a negative predictive value (NPV) of 99.6% were obtained with a single bilirubin determination applying Trend 12, while 82.5% of sensitivity and 99.4% of NPV were obtained with Trend 15. Two consecutive TSB determinations identified all infants reaching TSB values > 12 mg/dL and all neonates but 5 reaching TSB values > 15 mg/dL (92.1% of sensitivity and 99% of NPV) CONCLUSION: The hour-specific TSB determination in the first 3 days of life is able to predict all neonates at risk of nonphysiologic hyperbilirubinemia and could facilitate a safe discharge from the hospital and a targeted intervention and follow-up.
本文旨在评估出生后3天内的总血清胆红素（TSB）水平预测后续非生理性高胆红素血症的能力。
在一家一级新生儿病房收治的1496例足月儿中，前瞻性评估出生后第一周内特定时间的TSB值列线图的预测能力，如有可能，使用单个TSB值或两个连续的TSB值。
TSB值>12mg/dL的发生率为9.6%，而TSB>15mg/dL的发生率为2.6%。应用Trend 12进行单次胆红素测定时，敏感性为97.9%，阴性预测值（NPV）为99.6%；而应用Trend 15时，敏感性为82.5%，NPV为99.4%。连续两次TSB测定可识别所有TSB值>12mg/dL的婴儿以及除5例之外所有TSB值>15mg/dL的新生儿（敏感性为92.1%，NPV为99%）。结论：出生后3天内特定时间的TSB测定能够预测所有有非生理性高胆红素血症风险的新生儿，并有助于安全出院以及进行有针对性的干预和随访。
