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目的研究脐带血胆红素水平预测足月健康新生儿后续黄疸程度的价值。方法 523例足月健康新生儿,测定脐血胆红素、白蛋白水平,监测每日经皮胆红素值(TCB)。对时龄0～24 hTCB≥18;～48 h TCB≥21;～72 h TCB≥25;>72h≥25者,送检静脉血血清胆红素值(TSB),考虑是否需要光疗。将新生儿按脐血胆红素水平分为<30 μmol/L;≥30 μmol/L;≥36 μmol/L;≥42μmol/L,共4组。比较4组新生儿 TCB≥25、TSB>205 μmol/L、TSB>257 μmol/L 及需要光疗的发生率。对脐血胆红素水平预告新生儿黄疸进行分析。比较黄疸组新生儿和非黄疸组新生儿临床特征。结果脐血胆红素水平升高,各组新生儿 TCB≥25、TSB>205 μmol/L、TSB>257 μmol/L 和需要光疗的发生率增加。脐血胆红素水平用于预测新生儿黄疸发生有统计学意义(P<0.001)。黄疸组新生儿脐血胆红素值显著高于非黄疸组(t=10.96,P<0.001)。而脐血清白蛋白值(t=2.38,P>0.05)、妊娠周数(t=-0.90,P>0.05)、出生体重(t=0.10,P>0.05)比较,两组均无统计学差异。结论脐血胆红素水平用于预测足月健康新生儿后续黄疸的程度是一种有效的方法。
Objective To study the value of umbilical cord blood bilirubin in predicting the degree of follow-up jaundice in full-term healthy neonates. Methods 523 newborn infants with full-term health were enrolled in the study. The umbilical cord blood bilirubin and albumin levels were measured and the transcutaneous bilirubin (TCB) value was monitored. On the age of 0 ~ 24 hTCB ≥ 18; ~ 48 h TCB ≥ 21; ~ 72 h TCB ≥ 25;> 72 h ≥ 25 were sent to check venous serum bilirubin (TSB), consider the need for phototherapy. The neonatal umbilical cord blood bilirubin levels were divided into <30 μmol / L; ≥ 30 μmol / L; ≥ 36 μmol / L; ≥ 42 μmol / L, a total of 4 groups. The incidences of TCB≥25, TSB> 205 μmol / L, TSB> 257 μmol / L and phototherapy were compared among the four groups. Analysis of umbilical bilirubin levels in neonatal jaundice. Clinical characteristics of neonates with jaundice and non-jaundice groups were compared. Results The umbilical blood bilirubin level increased, the newborn infants in each group TCB ≥ 25, TSB> 205 μmol / L, TSB> 257 μmol / L and the need for phototherapy increased incidence. Cord blood bilirubin levels were used to predict neonatal jaundice statistically significant (P <0.001). The neonatal umbilical blood bilirubin value in jaundice group was significantly higher than that in non-jaundice group (t = 10.96, P <0.001). There was no significant difference in umbilical serum albumin (t = 2.38, P> 0.05), gestational age (t = -0.90, P> 0.05) . Conclusions The level of umbilical blood bilirubin is an effective method to predict the extent of follow-up jaundice in full-term healthy neonates.