Sato Yumi, Morioka Ichiro, Miwa Akihiro, Yokota Tomoyuki, Matsuo Kiyomi, Koda Tsubasa, Fujioka Kazumichi, Morikawa Satoru, Shibata Akio, Yokoyama Naoki, Takahashi Kaoru, Nishio Hisahide, Matsuo Masafumi
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Pediatr Int. 2012 Feb;54(1):81-5. doi: 10.1111/j.1442-200X.2011.03457.x. Epub 2011 Oct 17.
The American Academy of Pediatrics guidelines recommend that the total bilirubin (TB)/albumin (Alb) ratio (B/A ratio), instead of serum concentration of unbound bilirubin (UB), can be used with TB for determining treatment modality for jaundiced newborns ≥ 35 weeks of gestation. It is unknown, however, whether the B/A ratio is actually correlated with serum UB.
Four hundred and ninety-seven serum samples were obtained from 209 newborns ≥ 35 weeks of gestation, who were admitted to Kobe University Hospital. Serum UB concentration was measured using the glucose oxidase-peroxidase method. Serum TB and Alb concentrations were measured on spectrophotometry. B/A ratios were calculated and were linearly compared with serum UB. Furthermore, the accuracy of the B/A ratio was evaluated.
The B/A ratio was significantly correlated with serum UB concentration. A serum UB concentration of 0.6 µg/dL was in agreement with a B/A ratio of 0.5. For comparison of the number of newborns who had serum UB concentrations ≥ or <0.6 µg/dL and B/A ratios ≥ or <0.5, we found the following characteristics: the concordance rate between serum UB concentrations and the B/A ratio was 94%, sensitivity was 51%, and specificity was 99%.
The B/A ratio is significantly correlated with serum UB concentration in newborns ≥ 35 weeks of gestation. The B/A ratio, however, is underestimated when serum UB concentrations are >0.6 µg/dL.
美国儿科学会指南建议，对于孕周≥35周的黄疸新生儿，可使用总胆红素（TB）/白蛋白（Alb）比值（B/A比值）而非血清未结合胆红素（UB）浓度，结合TB来确定治疗方式。然而，B/A比值是否真的与血清UB相关尚不清楚。
从209例孕周≥35周、入住神户大学医院的新生儿中获取497份血清样本。采用葡萄糖氧化酶-过氧化物酶法测定血清UB浓度。用分光光度法测定血清TB和Alb浓度。计算B/A比值，并与血清UB进行线性比较。此外，还评估了B/A比值的准确性。
B/A比值与血清UB浓度显著相关。血清UB浓度为0.6μg/dL时，对应的B/A比值为0.5。为比较血清UB浓度≥或<0.6μg/dL且B/A比值≥或<0.5的新生儿数量，我们发现以下特征：血清UB浓度与B/A比值的一致率为94%，敏感性为51%，特异性为99%。
孕周≥35周的新生儿中，B/A比值与血清UB浓度显著相关。然而，当血清UB浓度>0.6μg/dL时，B/A比值会被低估。
