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。

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.