Abstract: Objective To determine whether transcutaneous bilirubin measurements(TcB) before and during phototherapy consist with total serum bilirubin(TSB) levels,in order to provide reference for the bilirubin monitoring during phototherapy. Methods A prospective observational study was conducted on full-term neonates requiring phototherapy and TSB measurements from March 2017 to May 2018.TcB measurement was collected within 3 minutes of blood for TSB measurements.The consistency of TcB and TSB was analyzed by Bland-Altman method. Results A total of 239 neonates were included,with the gestational age of (38.3±1.2) weeks and birth weight of (3.1±0.23)kg.Before starting phototherapy,the levels of TSB and TcB were (221.3±32.8) μmol/L and (227.5±33.9)μmol/L,respectively.During phototherapy,the levels of TSB and TcB were (188.6±35.2) μmol/L and (185.9±32.6) μmol/L,respectively.The Bland-Altman analysis demonstrated that before starting phototherapy the mean difference between TSB and TcB was (6.7±21.4) μmol/L (95% CI:-27.9-41.2)μmol/L,which was(-2.7±20.7)μmol/L (95% CI:-42.4-37.1)μmol/L during phototherapy. Conclusion The consistency between TcB measurement and TSB measurement is satisfying,indicating that both of them can be used to monitor bilirubin levels during phototherapy in jaundiced term infants.

Key words: neonate, jaundice, phototherapy, bilirubin

摘要： 目的 确定黄疸新生儿接受光疗期间经皮胆红素测量(TcB)与血清总胆红素测量结果(TSB)的一致性,为黄疸患儿光疗期间胆红素检测的方法选择提供依据。方法 2017年3月－2018年5月采用前瞻性的研究设计,连续纳入需要接受光疗和TSB测量的足月新生儿。光疗开始前和光疗期间分别测量TSB,并在测量TSB完成后的3 min内测量患儿TcB值。采用Bland-Altman分析TcB和TSB的一致性。结果 共纳入患儿239例,平均胎龄为(38.3±1.2)周,平均出生体重为(3.1±0.23) kg。在光疗开始前TSB和TcB分别为(221.3±32.8)μmol/L和(227.5±33.9)μmol/L;光疗期间分别为(188.6±35.2)μmol/L和(185.9±32.6) μmol/L。Bland-Altman分析显示,在光疗开始前TcB和TSB的均数差为(6.7±21.4)μmol/L(95％CI:-27.9~41.2 μmol/L);光疗期间为(-2.7±20.7) μmol/L(95％CI:-42.4~37.1 μmol/L)。结论 黄疸足月儿TcB和TSB的一致性较好,可用于光疗期间胆红素水平的监测。

关键词: 新生儿, 黄疸, 光疗, 胆红素