新生儿黄疸中碳氧血红蛋白检测的临床应用研究

CLINICAL EVALUATION OF MEASURING THE CARBOXYHEMOGLOBIN IN NEONATAL JAUNDICE

为探讨常见新生儿黄疸中碳氧血红蛋白(COHb)检测的临床价值,以德国800系列生化血气分析仪附加的270-血氧仪检测动脉化毛细血管血COHb,同步取静脉血检测血清总胆红素(STB)。病例选自本院新生儿病房2001年7月～2002年6月收治的伴有常见黄疸原因的足月新生儿157例[新生儿溶血病75例、感染51例、晚发性母乳性黄疸31例]。对照组101例为日龄匹配无病理性黄疸者,其中≤7天者52例,检测不同日龄的COHb,共测120例次。结果对照组中COHb生后5天内较高,峰值在1～2天,一周后接近成人正常水平。COHb与STB无相关性;溶血组COHb及STB均显著高于对照组(P<0.001),感染、母乳性黄疸组COHb与对照组比较差异无显著性(P>0.05)。结果提示COHb可用于证实新生儿黄疸中有无胆红素产量的增多,有助于黄疸病因的诊断。

To evaluate the clinical value of the level of carboxyhemoglobin(COHb) in neonatal jaundice. Arterial capillary blood COHb were detected by 270 CO-oximeter connected to 800 series system in 157 full term infants with the common causes of jaundice which including hemolytic disease of the newbom( n = 75), infective jaundice( re = 51), and breast milk jaundice( n = 31). Serum total bilirubin(STB) was measured at the same time. 101 cases without pathological jaundice in the same age were used as control group, among which COHb were detected in 52 cases within one week after birth for 120 times in different days of age. The result show: (1)The levels of COHb were higher in the first 5 days with the peak at 1 ~ 2 days in control group, then it declined near to the normal adult levels one week later. There was no correlation between COHb and STB. (2)COHb & STB were much higher in hemolytic disease than those in control group (P <0.001). While COHb showed no significant difference between infective jaundice and breast milk jaundice with the control groups. We conclude that the high levels of COHb indicate the production of bilirubin in neonatal jaundice is increased which is helpful to diagnose the cause of jaundice.