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马来西亚新生儿黄疸经皮与血清总胆红素测量的比较

Comparison between the Transcutaneous and Total Serum Bilirubin Measurement in Malay Neonates with Neonatal Jaundice.

作者信息

Mohamed Mazrah, Ibrahim Nor Rosidah, Ramli Noraida, Abdul Majid Noorizan, Yacob Najib Majdi, Nasir Ariffin

机构信息

Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

出版信息

Malays J Med Sci. 2022 Feb;29(1):43-54. doi: 10.21315/mjms2022.29.1.5. Epub 2022 Feb 23.

Abstract

BACKGROUND

This study aims to investigate the reliability of the Dräger Jaundice Meter JM-105 for the screening of neonatal jaundice in Malay neonates.

METHODS

A cross-sectional study was conducted in a university hospital involving 130 jaundiced neonates requiring serum bilirubin determination from day 2 to day 7 of life.

RESULTS

The mean total serum bilirubin (TSB) was 232 μmol/L, whereas the mean transcutaneous bilirubin (TcB) measured at the forehead and sternum were 222 μmol/L and 223 μmol/L, respectively. Further, TcB underestimates TSB with a mean difference of 10.10 μmol/L at the forehead and 9.27 μmol/L at the sternum. A positive linear relationship was observed between TSB with TcB forehead ( = 0.82) and TcB sternum ( = 0.80). A good discriminations ability was observed for both the TcB forehead (receiver operating characteristics [ROC] curve = 89.8%) and sternum (ROC curve = 89.7%) at a TSB level of 205 μmol/L. The sensitivity ranges from 84.4% to 85.3%, while the specificity ranges from 77.4% to 76.4%.

CONCLUSION

Our study demonstrates a strong linear relationship and good diagnostic accuracy of TcB values compared to TSB values. To conclude, TcB measured at the forehead or sternum is a good alternative as a non-invasive screening tool for non-severe hyperbilirubinemia in Malay neonates.

摘要

背景

本研究旨在调查德尔格黄疸仪JM - 105用于筛查马来新生儿黄疸的可靠性。

方法

在一家大学医院进行了一项横断面研究,纳入130例在出生后第2天至第7天需要测定血清胆红素的黄疸新生儿。

结果

血清总胆红素(TSB)的平均值为232μmol/L,而在前额和胸骨处测得的经皮胆红素(TcB)平均值分别为222μmol/L和223μmol/L。此外,TcB低于TSB,前额处平均差值为10.10μmol/L,胸骨处为9.27μmol/L。TSB与前额TcB(= 0.82)和胸骨TcB(= 0.80)之间观察到正线性关系。在TSB水平为205μmol/L时,前额TcB(受试者操作特征[ROC]曲线 = 89.8%)和胸骨TcB(ROC曲线 = 89.7%)均具有良好的鉴别能力。敏感性范围为84.4%至85.3%,特异性范围为77.4%至76.4%。

结论

我们的研究表明,与TSB值相比,TcB值具有很强的线性关系和良好的诊断准确性。总之,在前额或胸骨处测量的TcB作为马来新生儿非严重高胆红素血症的非侵入性筛查工具是一个很好的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f40a/8887975/b92159935b75/05mjms2901_oaf1.jpg

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