蓝光辐照度在高胆红素血症光疗疗效评价中的作用

EVALUATION OF THE EFFICACY OF BLUE-LIGHT PHOTOTHERAPY USING DIFFERENT IRRADIANCE IN NEONATES WITH HYPERBILIRUBINEMIA

目的:分析蓝光辐照度在新生儿高胆红素血症蓝光治疗疗效评估中的作用。方法:选取南京市大厂医院儿科2013年6月至2014年5月收治的高胆红素血症足月新生儿90例,将其随机分为新蓝光组、部分蓝光组及旧蓝光组,每组30例。3组分别应用不同使用时间的蓝光灯予以光照治疗,观察治疗前、后血清总胆红素水平(TSB)下降情况及其与光辐照度之间的相关性。结果:3组患儿临床特征及治疗前TSB差异无统计学意义[304.3(268.6,321.3)μmol/L vs 302.6(268.6,316.2)μmol/L vs 304.3(266.9,321.3)μmol/L,z=3.239,P=0.198],经过蓝光治疗后血清TSB水平均有下降,3组TSB水平呈递增状态[146.2(134.3,158.1)μmol/L vs 180.2(156.4,195.5)μmol/L vs 200.6(190.4,214.2)μmol/L,z=44.796,P=0.000]。3组光辐照度随蓝光灯使用时间延长而逐渐下降[(30.2±2.0)μW·cm^(-2)·nm^(-1) vs(24.3±2.8)μW·cm^(-2)·nm^(-1) vs(18.1±1.9)μW·cm^(-2)·nm^(-1),F=202.872,P<0.001)。Pearson相关分析显示,TSB下降辐度(△TSB)与光辐照度呈明显正相关关系(r=0.846,P=0.000)。结论:蓝光治疗的疗效与光辐照度有关,使用时间越长的蓝光灯光辐照度下降,治疗效果下降。

Objective ：To evaluate the efficacy of blue-light phototherapy using different irradiance in neo-nates with hyperbilirubinemia. Methods： 90 neonates with hyperbilirubinemia in our hospital from June 2013 to May 2014 were enrolled and randomly divided into the new blue-light group, partly ngroup and old blue-light group, each with 30 cases. The infants from different groups received different us-age time of blue light for phototherapy. The level of total serum bilirubin （TSB） and its correlation with ir- radiance were observed before and after treatment. Results： Before phototherapy, no significant difference was found in clinical characteristics and the TBS level among groups （ P 〉 0 . 05）. The TSB level was evi-dently lower in all groups after phototherapy than before （ P 〈 0. 01）. The light irradiance was inversely proportional to the usage time （ P 〈 0. 01）. Furthermore, the reduction degree of TSB was positively cor-related with light irradiance （ r =0. 846 ,P =0. 000）. Conclusion： The efficacy of blue-light phototherapy is related to the light irradiance, and the longer usage time of blue light lead to lower irradiance and poor effect.