关键词: 黄疸, 新生儿, 基于图像胆红素值, 经皮胆红素值, 血清总胆红素值

Abstract: Objective To evaluate the clinical application value of image-based bilirubin (IBB) detection of neonatal jaundice by smartphones. Methods The neonates with jaundice and birth weight > 2 500 g and without phototherapy were selected from the Neonatology Department of Suining County People's Hospital from December 2019 to April 2020.The total serum bilirubin (TSB), transcutaneous bilirubin (TcB) and IBB of infants were tested simultaneously.TSB and IBB were re-tested at the end of phototherapy and in 24 hours.The glabella of forehead was selected as detection sites of TcB and IBB.Sex, age, gestational age, birth weight, TSB and the mean value of three consecutive tests of TcB and IBB were recorded.The t test, paired t test, Pearson's correlation analysis and Bland-Altman plots consistency analysis were used. Results A total of 86 neonates were enrolled, including 46 males and 40 females.The median age was 7 days, the gestational age was (37.7±1.2) weeks, the birth weight was (3 197±396) g, and 57 cases were treated with blue light.Compared with TSB, the accuracy of IBB was similar to that of TcB [(0.32±1.11) mg/dl vs.(0.19±1.08) mg/dl, t=0.740, P=0.461].The accuracy of IBB and TcB in the subgroup with age ≤ 2 days was worse than that in the subgroup with age ＞ 2 days (t=-4.258,-3.617, P＜0.05).There was a good correlation (r=0.973) and a strong consistency (95.3% of the samples fell within the 95% consistency interval) between IBB and TSB.The accuracy of IBB at 0 hour after phototherapy was significantly inferior to that of IBB at 24 hours after phototherapy (t=-6.311, P＜0.001), and there is a moderate correlation (r=0.750) and poor consistency (only 91.2% of the samples fall within the 95% consistency interval) between IBB and TSB.At 24 hours after phototherapy, the correlation between IBB and TSB was still moderate (r=0.724), and the consistency improved (94.7% of the samples fell within the 95% consistency interval) between IBB and TSB. Conclusions The accuracy of IBB is similar to that of TcB, and there is a good correlation and a strong consistency between IBB and TcB.IBB is suitable for newborns with birth weight >2 500 g.It is a simple, quick and relatively accurate way to monitor neonatal jaundice dynamically at home after the mother is discharged from the hospital 2-3 days after delivery.

Key words: jaundice, neonates, image-based bilirubin, transcutaneous bilirubin, total serum bilirubin