干化学分析仪在新生儿胆红素检测中的应用

Application of Dry Chemistry Analyzer in Neonatal Bilirubin Detection

目的分析干化学分析仪在新生儿胆红素检测中出现的总胆红素(TBIL)与未结合胆红素(Bu)+结合胆红素(Bc)之和不相符的现象,对比TBIL和Bu+Bc在患儿治疗过程中的疗效评估应用价值。方法选取2016年11月—2017年5月间在广东省第二人民医院新生儿科进行治疗的新生儿高胆红素血症患儿86例。抽静脉血2~3ml,离心出血清后在Vitros 4600干生化分析仪上进行TBIL、Bc和Bu的测定,并挑选治疗前TBIL=Bu+Bc的3例患儿进行动态监测。结果治疗前的标本有72.1%测定为TBIL=Bu+Bc,治疗后69.8%的标本表现为TBIL<Bu+Bc,与治疗前相比,差异有统计学意义(P<0.05);3例患儿在整个治疗过程中大部分表现为TBIL<Bu+Bc。结论干生化分析仪在新生儿TBIL检测中的确存在不足,以Bu+Bc作为新生儿胆红素的检测值更能真实反映患儿体内胆红素的情况,给临床提供了更为真实有效的检验数据来评估患儿的治疗效果。

Objective To analyze the dismatch between TBIL and Bu ＋ Bc in Neonatal bilirubin detection through using dry chemistry analyzer. and compare the value of both in therapeutic effect valuation. Methods Collecting the clinical data of 86 newborns with hyperbilirubinemia in Guangdong Second People＇s Hospital from November,2016 to May,2017. Taking 2 ~ 3 ml serum detecting the TBIL and Bu ＋ Bc,and dynamically montoring three cases which show TBIL = Bu ＋ Bc prior treatment. Results 72. 1% prior treatment cases appear TBIL = Bu ＋ Bc. while 69. 8% specimen show TBIL Bu ＋ Bc. The difference is statistically significant through comparing with before treatment（P 0. 05）. And TBIL Bu ＋ Bc appear in 3 patients during the whole therapeutic process. Conclusion There is disadvantages in using dry biochemical analyzer to detect TBIL. Bu ＋ Bc can reflect the true situation of neonatal bilirubin,and provide the more real and effective test data for clinical to evaluate the treatment effect of children.