经皮黄疸测定仪检测新生儿总胆红素水平的可靠性分析

Reliability Analysis of Neonatal Total Bilirubin Level Determined by the Transcutaneous Jaundice Detector

目的:评价经皮黄疸测定仪与全自动生化分析仪检测新生儿总胆红素(TBIL)的相关性和一致性。方法:回顾性分析2017年6月至2019年6月在深圳市龙岗中心医院新生儿科住院治疗的新生儿高胆红素血症患儿383例。按全自动生化分析仪检测的TBIL值分为中度黄疸组198例、重度黄疸组120例和极重度黄疸组65例。同步使用经皮黄疸测定仪和全自动生化分析仪检测TBIL值,采用Spearman相关系数和Bland-Altman散点图分析两种检测方法TBIL值的相关性和一致性。结果:经皮黄疸测定仪和全自动生化分析仪检测TBIL值在不同程度黄疸组比较,差异均有统计学意义(P<0.01)。经皮黄疸测定仪和全自动生化分析仪两种方法检测TBIL值呈显著正相关(r=0.973,P<0.01);两种仪器检测TBIL值的一致性较差。结论:对于中、重度黄疸患儿经皮测定胆红素(TCB)是较好的监测工具,但是对于极重度黄疸患儿不能仅仅根据TCB进行管理,需要动态监测血清总胆红素(STB)。

Objective:To evaluate the correlation and consistency of neonatal total bilirubin(TBIL)determined by transcutaneous jaundice detector and automatic biochemistry analyzer.Methods:We retrospectively reviewed 383 neonates with hyperbilirubinemia who were hospitalized in the Department of Neonatology,Longgang District Central Hospital of Shenzhen from June 2017 to June 2019.According to TBIL values detected by automatic biochemistry analyzer,the patients were divided into the moderate jaundice group with 198 neonates,the severe jaundice group with 120 neonates,and the extremely severe jaundice group with 65 neonates.The TBIL values were determined simultaneously by transcutaneous jaundice detector and automatic biochemistry analyzer.The correlation and consistency of TBIL values determined by the two methods were analyzed by Spearman Correlation Coefficient and Bland-Altman Scatter Plot.Results:The differences of TBIL values of the neonates in all the groups with different degrees of jaundice determined by the two methods were significant(P<0.01).There was a significant positive correlation between TBIL values detected by transcutaneous jaundice detector and values by automatic biochemistry analyzer(r=0.973,P<0.01),but the consistency of TBIL values detected by the two instruments was poor.Conclusion:Transcutaneous bilirubin(TCB)is a better tool used to monitor children with moderate and severe jaundice,but for children with very severe jaundice,TCB alone is not enough and dynamic monitoring of serum total bilirubin(STB)is also needed.