219例壮族正常足月新生儿血清胆红素的动态监测

Dynamic monitoring of serum bilirubin level in 219 full-term newborns of Zhuang nationality

目的:了解壮族正常足月新生儿生理性黄疸早期血清胆红素的动态变化值,探索其与汉族的异同。方法:①用微量胆红素法测定219例壮族正常足月新生儿(1～7天)血清胆红素,将其按血清胆红素水平分为正常组和高胆组,比较两组间各种围产因素对血清胆红素的影响。②用同样方法测定280例汉族新生儿血清胆红素,将壮族、汉族新生儿分别设为研究组和对照组,比较两组间血清胆红素。结果:①壮族正常足月新生儿出生后第2～3天出现黄疸,第4天达到高峰,平均峰值为(188.29±35.87)μmol/L,≥220.5μmol/L者占22.83%,峰值的95%可信区间的上限为258.60μmol/L。男女性别两者比较:第1、2、3、7天差别无统计学意义(P>0.05),第4、5、6天差别有统计学意义(P<0.05)。②壮族新生儿血清胆红素平均峰值略高于汉族,但两组比较差别无统计学意义(P>0.05)。③在围产期因素中,壮族正常组与高胆组的比较:高胆组的母亲孕周小于正常组(P<0.01),婴儿出生体重、母亲年龄、母亲孕次两组比较差异无统计学意义(P>0.05)。结论:壮族正常足月新生儿黄疸出现的时间及峰值与汉族基本相同,亦与国内报道相似。监测壮族正常足月新生儿早期血清胆红素的动态变化,可为新生儿高胆红素血症的诊断提供依据。

Objective： To understand the early dynamic serum bilirnbin level caused by physiological jaundice among the normal full - term newborns of Zhuang nationality, explore their similarities and differences between Zhuang and Han nationality. Methods ： （1）The serum bilirubin levels of 219 full -term newborns （1 -7 days） of Zhuang nationality were detected by micro -determination method, then they were divided into normal level bilirubin group and high level bilirubin group, the effect factors of perinatal factors on bilirubin level were compared between two groups.（2） 280 full - term newborns of Han nationality were detected by the same method, newborns of Zhuang nationality were set as study group, while newborns of Han nationality were set as control group, the levels of bilirubin in two groups were compared. Results ： （3）Among the normal full - term newborns of Zhuang nationality, jaundice emerged in 2 - 3 days after birth, then reached to the peak level on the fourth day, the average peak value was （ 188. 29 ± 35. 87） μmol/L, the percentage of bilirubin level ≥ 220. 5 μmol/ L was 22.83% , the upper limit of 95% of credibility interval of peak value was 258. 60 mol/L. There was no significant difference on the first, second, third and seventh day after birth between different genders （ P 〉 0. 05 ） , but there was difference on the fourth, fifth and sixth day （P 〈 0. 05 ） . （3）The average peak value of bilirubin of newborns of Zhuang nationality was higher than that of Han nationality, but without significant difference （ P 〉 0.05 ） . （4）Among newborns of Zhuang nationality, the pregnant weeks of high level bilirubin group was shorter than that of normal level bilirubin group （ P 〈 0. 01 ） , but there was no significant difference in birth weight, the mothers＇ age and time of pregnancy between two groups （ P 〉 0.05 ） . Conclusion ： The jaundice appearance time and its peak value of normal full - term newborns of Zhuang nationality are almost the same as full - term newborns of Han nationality, the result is similar to the domestic reports. Dynamic monitoring of serum bilirnbin level in full - term newborns of Zhuang nationality can provide a basis for the diagnosis of early neonatal hyperbilirubinemia.