新生儿脐带血对病理性黄疸的早期预测

目的通过分析脐血血清中的总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、总蛋白（TP）、白蛋白（ALB）及脐血中的红细胞（RBC）、血红蛋白（Hb）、红细胞压积（Hct）、平均红细胞体积（MCV）、平均血红蛋白含量（MCH）、平均血红蛋白浓度（MCHC）指标与临床诊断为高胆红素血症新生患儿的相关性，从而评估脐血相关项目检测对早期新生儿病理性黄疸的预测价值。方法收集分娩的361例足月新生儿脐静脉血3ml，其中取1ml脐血进行血常规测定，取2ml脐血分离出血清进行肝功能测定。回顾性收集新生儿及其母亲临床病例数据，根据新生）L24h内是否出现黄疸及是否诊断为高胆红素血症，排除不合格数据，随机抽取200例，分为病理性黄疸组100例及暂时性黄疸组100例，比较两组间脐血以上指标结果，分析这些指标与早期新生儿病理性黄疸的关系。结果脐血中TP、ALB水平明显降低，Hb、MCV、MCH、TBIL、IBIL水平显著升高。结论脐血TBIL、IBIL、TP、ALB、Hb、MCV、MCH水平联合分析可用于预测早期新生儿病理性黄痘。

Objective To explore the value of umbilical cord related projects for early detection of neonatal jaundice through the analysis of total bilirubin in serum of umbilical cord blood （ TBIL ） , direct bilirubin （ DBIL ） , indirect bilirubin （ IBIL ） , total protein （ TP ） , albumin （ ALB ） and blood red blood cells （ RBC ） , hemoglobin （ Hb ） , hematocrit （Hct ） , mean corpuscular volume （ MCV ） , hemoglobin concentration （ MCH ） , mean hemoglobin concentration （ MCHC ） and correlation index for clinical diagnosis of neonatal hyperbilirubinemia. Methods 361 cases of newborn umbilical vein blood collection of 3ml in our hospital, which took lml umbilical cord blood routine test, 2ml cord blood separated the serum liver function were measured. Retrospectively collected clinical data of neonates and their mothers, according to neonatal jaundice within 24 hours and whether with the diagnosis of hyperbilirubinemia, unqualified data was eliminated, 200 cases of random sampling was divided into two groups. The pathological jaundice group 100 cases and temporary jaundice group 100 cases, comparison between the two groups of umbilical cord blood of above index Results, Analysis of umbilical cord blood between these indicators, and the concentration of early neonatal jaundice. Results TP and ALB reduced significantly. Hb, MCV, MCH, TBIL and IBIL increased significantly in Cord blood. Conclusions Combined analysis of TBIL, IBIL, TP, ALB, Hb, MCV and MCH levels in umbilical cord blood can be used to predict pathologic jaundice in early neonates.