足月新生儿黄疸的早期预测

Early prediction of jaundice among normal full-term neonates

目的 通过早期监测新生儿血清胆红素（SB），预测新生儿的黄疸程度。方法 （1）用微量法出生后1．3d的SB水平值，其中560例正常足月儿为正常组，221例有明显黄疸病因的不同程度黄疸的足月新生儿为黄疸组，比较两组的SB水平值。（2）将黄疸组的新生儿按病因分为ABO溶血组、感染组、G6PD缺陷组、母乳性黄疸组、母亲为HBsAg阳性组，分析比较其各组出生后1—3dSB水平。结果 （1）黄疸组出生后1、2、3d的SB值分别为（94．51±24．60）、（177．48±43．04）、（229．10±42．96）μmol／L，均明显高于正常组（P〈0．01）。（2）黄疸组出生后1dSB〉103μmol／L的发生率为29．86％，出生后2dSB〉154μmmol／L／d发生率为66．97％，出生后3dSB〉205μmol／L的发生率为53．85％，均高于正常组（P〈0．01）。（3）在5组比较中出生后1d和2d的sB值经，检验，差别有统计学意义（P〈0．05）。结论 早期监测SB值，可预测新生儿黄疸及黄疸程度。

Objective To predict jaundice level（degrec）of neonates through early serum bilirubin（SB） monitoring. Methods 1. SB of 781 normal full-term neonates（lst to 3 rd day） were detected with a micro-method. The neonates were divided into two groups,560 cases of normal neonates formed the normal group,221 cases of obvious different degree jaundice formed the jaundice group ,and compared their SB value. 2. The jaundice group of neonates was divided into following groups according to the cause of diseases： ABO hemolysis group, infection group, G6PD deficiency group,jaundice caused by mother＇s milk group,and mother with HBsAg（ ＋ ）group,and compared their SB value （1st to 3 rd day）. Results 1. In the jaundice group ,the SB value interval was 94.51± 24. 60,177.48±43.04, and 229. 10± 42.96 μmol/L on the 1 st ,2nd, and 3 rd day after neonates were born respectively,these SB values were much higher than those in the normal group（P 〈0.01 ）. 2. Among the jaundice group,those SB 〉 103 μmol/L on the 1st day accounted for 29. 86% ,SB 〉 154 μmol/L on the 2nd day accounted for 66.97% ,SB 〉205μmol/L on the 3 rd day accounted for 53.85% ,they were much higher than those in the normal group（P 〈0.01 ）. There was significant difference in the SB value on the first day and the second day among five groups by F test （P 〈 0.05 ）. Conclusion Early serum bilirubin（SB） monitoring may play an important role in the prediction of icterus neonatorum and jaundice degree.