CAJ | 학술논문

目的绘制健康黄种新生儿出生后120h内经皮胆红素（TCB）水平随时间变化的TCB-时间百分位曲线图，为新生儿黄疸的评价提供依据。方法3118例健康新生儿，根据不同产式、不同胎龄及是否需要光疗分别分为顺产和剖宫产组；足月儿、早产儿和过期产儿组；非光疗组和光疗组。所有新生儿均在出生后12~120h内定时测定TCB数据。并针对不同组别的TCB改变情况作相关分析，同时绘制TCB-时间百分位曲线图。结果（1）TCB-时间百分位曲线图反映了健康黄种新生儿出生后120h内TCB水平的自然演变过程。（2）不同分娩方式对健康新生儿TCB水平的影响无统计学差异（P＞0.05）。（3）足月儿与过期产儿组各个时间点TCB均值均无统计学差异（均P＞0.05）。但早产儿组TCB均值于出生96h后明显大于足月儿及过期产儿组（均P＜0.05）。（4）光疗组TCB增长速率虽明显大于非光疗组（P＜0.05），但在出生后24h内两者百分位曲线也有潜在重叠的部分。结论TCB-时间百分位曲线反映了健康黄种新生儿生后120h内的TCB水平自然演变过程，此变化过程与血清胆红素（TSB）改变相互吻合。接近足月的健康早产儿在出院后应进行TCB定期随访，以预防高胆红素血症的发生。
목적회제건강황충신생인출생후120h내경피담홍소（TCB）수평수시간변화적TCB-시간백분위곡선도，위신생인황달적평개제공의거。방법3118례건강신생인，근거불동산식、불동태령급시부수요광료분별분위순산화부궁산조；족월인、조산인화과기산인조；비광료조화광료조。소유신생인균재출생후12~120h내정시측정TCB수거。병침대불동조별적TCB개변정황작상관분석，동시회제TCB-시간백분위곡선도。결과（1）TCB-시간백분위곡선도반영료건강황충신생인출생후120h내TCB수평적자연연변과정。（2）불동분면방식대건강신생인TCB수평적영향무통계학차이（P＞0.05）。（3）족월인여과기산인조각개시간점TCB균치균무통계학차이（균P＞0.05）。단조산인조TCB균치우출생96h후명현대우족월인급과기산인조（균P＜0.05）。（4）광료조TCB증장속솔수명현대우비광료조（P＜0.05），단재출생후24h내량자백분위곡선야유잠재중첩적부분。결론TCB-시간백분위곡선반영료건강황충신생인생후120h내적TCB수평자연연변과정，차변화과정여혈청담홍소（TSB）개변상호문합。접근족월적건강조산인재출원후응진행TCB정기수방，이예방고담홍소혈증적발생。
Objective To develop hour- specific transcutaneous bilirubin (TCB) nomogram for healthy Chinese neonates. Methods TCB levles were measured with BiliCheck bilirubinometer from 12 to 120 postnatal hours in 3118 neonates. The neonates were divided into vaginal and cesarean groups according to delivery mode;term infants, premature infants and post-term infants groups according to gestational age;phototherapy and non- phototherapy groups according to requirement of pho-totherapy. The dynamic changes of TCB levels were analyzed, the TCB percentiles for each time points were calculated and the hour- specific nomogram was developed. Results There was no significant difference in TCB levels between neonates with dif-ferent delivery mode (P>0.05). There was no difference in TCB levels between term infants and postterm infants (P>0.05);but the TCB levels in preterm infants were higher than those in term infants and postterm infants after 96h (P<0.05 ). The increasing rate of TCB in phototherapy group was higher than that in non- phototherapy group (P<0.05), however there was stil substantial overlap of TCB values between two groups within 24 postnatal hours. Conclusion The hour- specific TCB nomogram for TCB levels in healthy Chinese neonates in the first 120 postnatal hours has been developed successfully and the TCB levels is coin-cided with total serum bilirubin(TSB) levels. In order to prevent neonatal hyperbilirubinemia, attention should be paid for TCB lev-els in healthy neonates, especial y in those healthy premature neonates.