足月新生儿微量血胆红素的测定及其临床应用

Microdose blood detection and clinical application of the serum bilirubin in mature newborns

目的 :(1)制定清远地区足月新生儿不同日龄 (1～ 10d)的微量血胆红素动态变化值 ;(2 )探讨黄疸的临床分度与微量血胆红素测定值的相关性。方法 :5 0 0例正常足月新生儿为A组 ,于出生后第 1～ 10d ,每天同一时间测定微量血胆红素一次 ;2 0 0例黄疸组为B组 ,于出生后第 3～ 7d每天测一次微量血胆红素 ,由专人用双盲法对黄疸进行分度 ,分别计算出相应胆红素 (SB)均值及标准差。结果 :(1)正常足月新生儿生后第 2～ 3d开始出现黄疸 ,第 5～ 6d达高峰 ,平均峰值为(2 12 2 5± 5 7) μmol/L ,第 10d下降至 (171 4 5± 2 8 8) μmol/L ,男女性别无显著性差异 (P >0 0 5 )。(2 )临床判断无、轻度、中度、重度黄疸所对应的胆红素分别为 (12 8 2 5± 33 6 0 )、(2 0 2 35± 4 3 0 5 )、(2 6 3 70± 6 4 2 0 )、(2 95 5 0± 5 1 90 ) μmol/L。 结论 :正常足月新生儿黄疸出现的时间与国内外其他报道相似 ,但其生理性黄疸的诊断标准略高于传统标准。当胆红素大于相应的 x±s、 x± 2s或临床诊断为中度、重度黄疸 ,则应给予适当治疗。

Aim: To establish a bilirubin normal value in term breast_feeding neonates and assess the role of this value in the diagnosis of neonatal jaundice. Methods: The serum bilirubin (SB) values were measured by APEL BIL READ total bilirubin meter in 500 term breast-feeding newborns who were longitudinally evaluated 1～10 days after birth, and 200 neonatals with various degree of jaundice were evaluated from 3 to 10 days of age. Standard statistical methods were used to analyse the data. Results: Jaundice was detected in 2～3 days of age for most newborns. The bilirubin level usually reached to a peak level of (212.25±57) μmol/L at 5～6 days of age and then gradually declining to (171.45±28.8) μmol/L at 10th and clinically, normal mild to severe neonatal jaundice, the bilirubin values were (128.25±33.60)μmol/L, (202.25±43.64)μmol/L, (263.70±64.20)μmol/L and (295.50±51.90)μmol/L, respectively. Conclusion:The time of neonatal jaundice developed in term newborns is similar to the previous studies. The diagnostic criteria for physiological jaundice is slightly higher than previous traditional criteria and the SB normal value of this study is a good predicator for neonatal jaundice.