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经皮胆红素测定与血清胆红素在新生儿黄疸中的比较

Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice.

作者信息

Mahram Manoochehr, Oveisi Sonia, Jaberi Najmeh

机构信息

Department of Pediatrics, Children Growth Research Center, Qazvin University of Medical Science, Qazvin, Iran.

Department of Community of Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.

出版信息

Acta Med Iran. 2015 Dec;53(12):764-9.

PMID:26749233
Abstract

Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children's Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates.

摘要

高胆红素血症是新生儿常见问题,可导致严重并发症。因此,应进行胆红素的系列测量。这种评估通过血清样本的两种实验室测量方法和经皮胆红素测定仪来完成。这项描述性研究比较了经皮胆红素评估和实验室血清胆红素。对因新生儿间接性黄疸入住伊朗加兹温市古德儿童医院的256例新生儿,通过前额和胸骨两个部位的经皮胆红素测定法以及血清胆红素的实验室测量,评估其胆红素水平。病例为体重2500克及以上的非溶血性黄疸足月儿,且未接受过光疗或其他治疗。排除患有溶血性黄疸、败血症及疑似代谢紊乱的新生儿。记录并分析通过KJ - 8000经皮胆红素测定仪在前额和胸骨两个部位进行的评估以及血清胆红素的实验室测量结果。当前研究结果显示血清胆红素与经皮前额胆红素评估之间的相关性为0.82,所用设备的灵敏度为0.844;特异性为0.842,约登指数为0.709,截断值为12.4时参与者胆红素的最短距离为0.042。此外,阳性似然比和阴性似然比(LR)分别为5.665和0.164,诊断比值比(LR+/LR-)为34.56。经皮胆红素测定可被视为评估足月儿新生儿黄疸筛查中胆红素的可靠工具。

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Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice.经皮胆红素测定与血清胆红素在新生儿黄疸中的比较
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The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants.在患有疾病的婴儿接受光疗时,检查经皮胆红素,额头比胸骨更适合。
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