一项前瞻性队列研究,旨在确定一家三级医院中患有高胆红素血症的新生儿经皮胆红素值与血清胆红素值之间的相关性

Anushree Cs, Rashmi Bv, R. Aggarwal
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引用次数: 0

摘要

导言大约 60% 的足月新生儿和 80% 的早产儿会出现高胆红素血症。估计血清总胆红素(TSB)是金标准方法,也是新生儿抽血的最常见原因。经皮胆红素(TCB)估测等无创方法是胆红素估测的替代方法。因此,本研究的主要目的是比较这两种方法的有效性。方法:本研究于 2020-2022 年期间在班加罗尔纳拉亚纳健康城的马祖姆达尔-肖医疗中心对 836 名新生儿(大于 35 周,体重≥2000gm)进行了前瞻性观察研究,旨在比较 TSB 和经皮胆红素(TCB)值,使用 JM-105 胆红素仪评估不同部位覆盖和未覆盖皮肤在治疗前、治疗期间和光疗期间的 TCB 值,并通过线性回归和 BlandAltman 分析将其与血清胆红素值相关联。前额、胸骨和耻骨联合处的 TSB 值与 TCB 值呈正相关,其中前额的相关性最强(r-0.826,p0.05)。TCB 临界值(13.75 毫克/分升)对停止光疗的灵敏度(78.5%)和特异度(64.5%)(ROC AUC 0.774,P<0.05)。结论:TCB 可作为胆红素估测的无创筛查工具,无需反复抽血。不过,在光疗监测期间,TCB 的可靠性仍需谨慎。这项研究为 TCB 的临床应用提供了有价值的见解,并为最佳使用提供了实用建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A PROSPECTIVE COHORT STUDY TO DETERMINE CORRELATION BETWEEN TRANSCUTANEOUS BILIRUBIN AND SERUM BILIRUBIN VALUES IN NEONATES WITH HYPERBILIRUBINEMIA IN A TERTIARY CARE HOSPITAL
Introduction: Hyperbilirubinemia is a major health condition seen in approximately 60% of term and 80% preterm neonates. Total serum bilirubin (TSB) estimation is the gold standard method and is the most common reason of blood drawing in neonates. Non-invasive method like transcutaneous bilirubin (TCB) estimation is an alternative for bilirubin estimation. Thus, the primary aim of present study is to compare the efficacy of the two methods. Th Methods: is prospective observational study was conducted between 2020-2022 on 836 neonates (>35 weeks, ≥2000gm) at Mazumdar Shaw Medical Centre, Narayana health city, Bangalore aimed to compare TSB and transcutaneous bilirubin (TCB) values using JM-105 bilirubinometer assessed TCB values taken before, during and phototherapy from covered and uncovered skin of different sites and correlated with the serum bilirubin values, through linear regression and Bland Altman analysis. Positive correlations were observed between TSB and TCB values at the forehead, st Results: ernum, and pubic symphysis, with the strongest correlation at the forehead (r-0.826, p<0.001) pre-phototherapy. Correlation weakened during and after phototherapy, notably at the forehead post-phototherapy (r-0.121, p>0.05). The preferred TCB estimation site was forehead pre- and 12 hours post-phototherapy with mean difference of 2.15±2.1 mg/dl and 0.6±2.13 mg/dl respectively, while sternum was favored site at 24 hours post-phototherapy; with mean difference of 2.01±2.32 mg/dl.TCB cut-off values (13.75mg/dl) demonstrated sensitivity (78.5%) and specificity (64.5%) for discontinuing phototherapy (ROC AUC 0.774, p<0.05). TCB proves effective as a non-invasive screenin Conclusion: g tool for bilirubin estimation, alleviating the need for repeated blood draws. However, caution is advised regarding TCB's reliability during phototherapy monitoring. The study provides valuable insights into TCB's clinical applicability, offering practical recommendations for optimal usage.
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