Department of Pediatrics, Oakland University William Beaumont School of Medicine and Division of Neonatology, Beaumont Children's Hospital, Royal Oak, MI 48073, USA.
J Perinatol. 2011 Sep;31(9):621-4. doi: 10.1038/jp.2011.5. Epub 2011 Feb 3.
The use of transcutaneous bilirubin (TcB) measurements has been studied extensively in the newborn population, but there have been few studies in outpatient populations and none from the offices of practicing pediatricians.
We performed TcB measurements on a mixed-race population of 120 jaundiced infants, ≥ 35 weeks of gestation, in two hospital-based outpatient clinics, a regional public health nurse follow-up program and two pediatric office practices. Three individual TcB readings were obtained from the mid-sternum, and the average and maximum values were recorded.
There was good correlation between the TcB and total serum bilirubin (TSB) measurements (r=0.78, P=0.0). 59% of TSB's were ≥15 mg dl(-1) and, although the number of false-negative readings increased when the TSB values exceeded 15 mg dl(-1), it was nevertheless possible to use TcB measurements to accurately predict the risk of TSB levels ≥ 15 mg dl(-1).
In outpatient settings, a TcB measurement with the JM-103 provides a reliable screening method for the identification of hyperbilirubinemia even when the TSB level exceeds 15 mg dl(-1). Using the maximum of three independent measurements reduces the number of false negatives, but increases the number of false positives. The use of TcB measurements in an outpatient practice should be a valuable tool for the practitioner.
经皮胆红素（TcB）测量在新生儿群体中得到了广泛研究，但在门诊人群中研究较少，在执业儿科医生的诊室中则尚无研究。
我们在两家医院的门诊诊所、一个区域公共卫生护士随访计划和两家儿科诊所，对 120 名胎龄≥35 周的混合种族黄疸婴儿进行了 TcB 测量。从胸骨中部获得三个单独的 TcB 读数，并记录平均值和最大值。
TcB 与总血清胆红素（TSB）测量值之间存在良好的相关性（r=0.78，P=0.0）。59%的 TSB 值≥15mg/dl（-1），尽管当 TSB 值超过 15mg/dl（-1）时，假阴性读数的数量增加，但仍可以使用 TcB 测量值准确预测 TSB 值≥15mg/dl（-1）的风险。
在门诊环境中，即使 TSB 水平超过 15mg/dl（-1），JM-103 的 TcB 测量也可以提供一种可靠的筛选方法来识别高胆红素血症。使用三个独立测量的最大值可以减少假阴性的数量，但会增加假阳性的数量。在门诊实践中使用 TcB 测量值应为医生提供有价值的工具。
