毛细管法和经皮法与血清生化法在黄疸新生儿胆红素水平中的相关性

Kazım Darka, Ali Gül
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摘要

研究目的经皮胆红素(TcB)测量是治疗新生儿黄疸病人的一种无创、简便、快速、廉价的方法,本研究旨在将其与标准方法--总血清胆红素(TSB)测量值进行比较。从相关性角度考虑,研究还包括毛细管胆红素的同步测量值。我们研究了使用 TcB 测量值代替抽血进行黄疸评估是否安全:2023 年 1 月 1 日至 2023 年 7 月 1 日期间,Gaziosmanpaşa 大学医学院(土耳其托卡特)新生儿重症监护室收治了 37-42 周妊娠黄疸新生儿。对确诊为新生儿黄疸的患者进行了回顾性分析。患有产前或产后疾病、ABO-Rh 血型不相容和早产-产后新生儿的患者被排除在研究之外。此外,研究还包括首次接受光疗且无输血史的患者。研究结果72 名患者均为足月新生儿。平均胎龄为 37.26 周(范围为 37-40 周),平均体重为 2789±15 克(2255-4550 克)。31名(43.1%)新生儿为男性。三名新生儿的直接库姆斯试验结果为 1+,一名新生儿为 4+。治疗前后的 TcB 胆红素水平与 TSB 值之间存在很强的相关性(r = 0.776,p < 0.001;r = 0.773,p < 0.001)。治疗前后毛细管胆红素和 TSB 测量值之间存在很强的相关性(r = 0.875,p < 0.001;r = 0.899,p < 0.001):在我们的研究中,我们发现光疗前后经皮胆红素测量值、血清胆红素测量值和通过耳部进行的毛细管法测量值之间存在很强的相关性。然而,由于这项研究的规模较小,我们不能建议在做出治疗决定时仅使用经皮胆红素测量法。
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Correlation of Capillary Tube and Transcutaneous Methods with Serum Biochemistry in Bilirubin Levels in Neonates with Jaundice
Objective: The aim of this study was to compare transcutaneous bilirubin (TcB) measurement, which is a noninvasive, easy, fast and inexpensive method in the treatment of patients with neonatal jaundice, with total serum bilirubin (TSB) measurement values, which is the standard method. Simultaneous capillary tube bilirubin values were also included in the study in terms of correlation. We investigated whether it would be safe to use TcB measurement instead of blood sampling for jaundice assessment. Materials and Methods: Between January 1, 2023 and July 1, 2023, newborns with gestational jaundice aged 37-42 weeks who were hospitalized with neonatal jaundice were enrolled in the neonatal intensive care unit of Gaziosmanpaşa University Faculty of Medicine (Tokat, Turkey). Patients with confirmed neonatal jaundice were retrospectively analyzed. Patients with antenatal or postnatal disease, ABO-Rh blood group incompatibility, and preterm-post-term neonates were excluded from the study. In addition, those who received phototherapy for the first time and did not have a history of transfusion were included in the study. Results: All 72 patients were term neonates. The mean gestational age was 37.26 weeks (range, 37-40 weeks) and the mean weight was 2789 ± 15 g (2255-4550 g). Thirty-one (43.1%) of the newborns were male. The direct Coombs test was 1+ in three newborns and 4+ in one newborn. There was a strong correlation between TcB bilirubin levels and TSB values before and after treatment (r = 0.776, p < 0.001; r = 0.773, p < 0.001, respectively). A strong correlation was observed between capillary tube bilirubin and TSB measurement values before and after treatment (r = 0.875, p < 0.001; r = 0.899, p < 0.001, respectively). Conclusion: In our study, we found a strong correlation between transcutaneous bilirubin measurement, serum bilirubin and capillary tube method performed through the ear before and after phototherapy treatment. However, due to the small size of this study, we cannot recommend the use of transcutaneous measurement alone in making treatment decisions.
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