探讨足月新生儿脐血胆红素水平对新生儿高胆红素血症的预测价值

J. M. Reddy, J. Umesh
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引用次数: 1

摘要

背景:在出生最初几天出现临床黄疸的婴儿更有可能发展为高胆红素血症。高胆红素血症是新生儿最常见的医学问题。它是新生儿早期再入院的最重要原因,也是新生儿发病率的主要原因。目的:在这项前瞻性研究中,我们将评估脐带胆红素水平对识别足月新生儿后续高胆红素血症的预测价值。材料和方法:对291例新生儿进行出生时脐带胆红素水平和随后72h血清胆红素水平的评估。估计临界值超过该临界值即存在显著的高胆红素血症。统计学包括定量数据,用均值和标准差表示;定性数据用比例和接收算子特征曲线表示,用来寻找截止值,寻找灵敏度和特异性。结果:脐带胆红素>2 mg/dl临界值对后续高胆红素血症的敏感性和特异性分别为77.97和56.90%,阳性预测值为31.51,阴性预测值为91.03%。结论:脐带血清胆红素可作为早期新生儿黄疸的筛查工具,尤其是在资源有限的我国,对新生儿高胆红素血症的预测具有广泛的意义,以减轻重症新生儿黄疸未经治疗的重大负担。
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To Study the Predictive Value of Umbilical Cord Blood Bilirubin Levels Term Neonates as Marker of Neonatal Hyperbilirubinemia
Background: Infants who are clinically jaundiced in the first few days are more likely to develop hyperbilirubinemia. Hyperbilirubinemia is the most common medical problem in newborn infants. It is the most important cause for hospital readmissions during the early neonatal period and also the cause for neonatal morbidity. Objective: In this prospective study we are going to evaluate the predictive value of cord bilirubin level for identifying term neonates for subsequent hyperbilirubinemia. Materials and Methods: Cord bilirubin levels at birth and subsequently serum bilirubin levels at 72 h were assessed in 291 neonates. The cutoff value was estimated beyond which there was significant hyperbilirubinemia. Statistics employed include quantitative data which is expressed in terms of mean and SD and qualitative in terms of proportions and receiver operator characteristic curve used to find cut-off value and to find sensitivity and specificity. Results: The cutoff value of cord bilirubin >2 mg/dl had sensitivity and specificity of 77.97 and 56.90%, respectively, with positive predictive value of 31.51 and negative predictive value of 91.03% for subsequent hyperbilirubinemia. Conclusion: To decreases the significant burden of untreated severe neonatal jaundice, cord serum bilirubin can be used as a screening tool to identify the neonatal jaundice in term and this prediction of neonatal hyperbilirubinemia has widespread implication especially in our country where there are limited resources.
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