结膜黄疸——黄疸新生儿临床相关高胆红素血症的一个重要但被忽视的体征。

Conjunctival Icterus - An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates.

作者信息

Azzuqa Abeer, Watchko Jon F

机构信息

Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, 15213, Pennsylvania. United States.

Division of Newborn Medicine, Department of Pediatrics, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, Pennsylvania 15213. United States.

出版信息

Curr Pediatr Rev. 2017;13(3):169-175. doi: 10.2174/1573396313666170718145535.

DOI:10.2174/1573396313666170718145535

PMID:28721815

Abstract

BACKGROUND

Conjunctival icterus is a largely neglected physical sign that may be helpful in identifying neonates with clinically relevant hyperbilirubinemia by practitioners in the hospital and outpatient clinic or parents at home.

OBJECTIVE

A recent NICU based study reported that conjunctival icterus is often a sign of significant (TSB ≥ 17 mg/dl) hyperbilirubinemia and TSB levels ≥ 76th-95th percentile on the Bhutani nomogram. In contrast, others report that conjunctival icterus, although frequently present at high TSB levels, may also be detected at lower TSB concentrations; suggesting instead that its absence may help to rule out significant hyperbilirubinemia.

RESULT AND CONCLUSION

The current review details the nature of conjunctival icterus and presents new data on its clinical occurrence in relation to TSB levels that re-affirm its correlation with elevated TSB concentrations and use to trigger TSB measurement in the jaundiced neonate.

摘要

背景

结膜黄疸是一个在很大程度上被忽视的体征，医院和门诊的从业者或在家中的父母可通过它来识别患有临床相关高胆红素血症的新生儿。

目的

最近一项基于新生儿重症监护病房（NICU）的研究报告称，结膜黄疸通常是显著（经皮胆红素（TSB）≥17mg/dl）高胆红素血症以及根据布塔尼列线图TSB水平≥第76至95百分位数的体征。相比之下，其他人报告称，结膜黄疸虽然常在高TSB水平时出现，但也可能在较低TSB浓度时被检测到；这反而表明其不存在可能有助于排除显著的高胆红素血症。