中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2015年
1期
20-23
,共4页
ABO血型系统%血型不合%高胆红素血症,新生儿%胆红素%胎血
ABO血型繫統%血型不閤%高膽紅素血癥,新生兒%膽紅素%胎血
ABO혈형계통%혈형불합%고담홍소혈증,신생인%담홍소%태혈
ABO blood-group system%Blood group incompatibility%Hyperbilirubinemia,neonatal%Bilirubin%Fetal blood
目的 研究脐血胆红素水平预测ABO溶血病足月儿发生高胆红素血症的价值.方法 回顾性分析同济大学附属第一妇婴保健院新生儿科2011年8月1日至2012年7月31日收治的292例足月ABO溶血病患儿的脐血胆红素水平.比较发生高胆红素血症(高胆组,34例)和未发生高胆红素血症(非高胆组,258例)患儿的临床特征.采用配对f检验、x2检验和Spearman相关分析对数据进行分析.构建受试者工作特性(receiver operating characteristic,ROC)曲线,分析脐血胆红素水平预测高胆红素血症的准确度及界值(cut-off point). 结果 高胆组34例患儿平均脐血胆红素水平为(52.4±13.2) μmol/L,明显高于非高胆组的(35.0±8.0) μmol/L(t=7.540,P=0.001).脐血胆红素水平与高胆红素血症发生率明显相关(x2=113.715,P＜0.001; rs=7.19,P＜0.001).新生儿脐血胆红素水平为50μmol/L时,发生黄疸的阳性预测值为0.683,阴性预测值为0.959,敏感性为0.690,特异性为0.958,ROC曲线下面积为0.882 (95％CI:0.873～0.891,P＜0.001).结论 脐血胆红素水平可作为预测ABO溶血病足月儿发生黄疸及预测黄疸程度的有效指标.
目的 研究臍血膽紅素水平預測ABO溶血病足月兒髮生高膽紅素血癥的價值.方法 迴顧性分析同濟大學附屬第一婦嬰保健院新生兒科2011年8月1日至2012年7月31日收治的292例足月ABO溶血病患兒的臍血膽紅素水平.比較髮生高膽紅素血癥(高膽組,34例)和未髮生高膽紅素血癥(非高膽組,258例)患兒的臨床特徵.採用配對f檢驗、x2檢驗和Spearman相關分析對數據進行分析.構建受試者工作特性(receiver operating characteristic,ROC)麯線,分析臍血膽紅素水平預測高膽紅素血癥的準確度及界值(cut-off point). 結果 高膽組34例患兒平均臍血膽紅素水平為(52.4±13.2) μmol/L,明顯高于非高膽組的(35.0±8.0) μmol/L(t=7.540,P=0.001).臍血膽紅素水平與高膽紅素血癥髮生率明顯相關(x2=113.715,P＜0.001; rs=7.19,P＜0.001).新生兒臍血膽紅素水平為50μmol/L時,髮生黃疸的暘性預測值為0.683,陰性預測值為0.959,敏感性為0.690,特異性為0.958,ROC麯線下麵積為0.882 (95％CI:0.873～0.891,P＜0.001).結論 臍血膽紅素水平可作為預測ABO溶血病足月兒髮生黃疸及預測黃疸程度的有效指標.
목적 연구제혈담홍소수평예측ABO용혈병족월인발생고담홍소혈증적개치.방법 회고성분석동제대학부속제일부영보건원신생인과2011년8월1일지2012년7월31일수치적292례족월ABO용혈병환인적제혈담홍소수평.비교발생고담홍소혈증(고담조,34례)화미발생고담홍소혈증(비고담조,258례)환인적림상특정.채용배대f검험、x2검험화Spearman상관분석대수거진행분석.구건수시자공작특성(receiver operating characteristic,ROC)곡선,분석제혈담홍소수평예측고담홍소혈증적준학도급계치(cut-off point). 결과 고담조34례환인평균제혈담홍소수평위(52.4±13.2) μmol/L,명현고우비고담조적(35.0±8.0) μmol/L(t=7.540,P=0.001).제혈담홍소수평여고담홍소혈증발생솔명현상관(x2=113.715,P＜0.001; rs=7.19,P＜0.001).신생인제혈담홍소수평위50μmol/L시,발생황달적양성예측치위0.683,음성예측치위0.959,민감성위0.690,특이성위0.958,ROC곡선하면적위0.882 (95％CI:0.873～0.891,P＜0.001).결론 제혈담홍소수평가작위예측ABO용혈병족월인발생황달급예측황달정도적유효지표.
Objective To evaluate the predictive value of cord blood bilirubin levels for subsequent neonatal hyperbilirubinemia in term infants with ABO hemolytic disease.Methods A total of 292 term newborns with ABO hemolytic disease admitted from August 1,2011 to July 31,2012 were enrolled.Cord blood bilirubin levels were analyzed and the clinical characteristics of the neonatal hyperbilirubinemia group (n=34) and non-hyperbilirubinemia group (n=258) were compared.A receiver operating characteristic (ROC) curve analysis was performed to identify the predictive value of the occurrence and cut-off point of hyperbilirubinemia in term infants with ABO hemolytic disease.Paired-t-test,Chi-square test and Spearman correlation were used for statistical analysis.Results Of the 292 term infants with ABO hemolytic disease,34 cases had hyperbilirubinemia,with an incidence of 11.6％.Cord blood bilirubin levels were significantly associated with the presence of hyperbilirubinemia.The mean cord blood bilirubin level in infants who developed hyperbilirubinemia was (52.4± 13.2) μ mol/L,and was (35.0±8.0) μ mol/L for those who did not develop hyperbilirubinemia (t=7.540,P=-0.001).When cord blood bilirubin concentration increased,the incidence of hyperbilirubinemia gradually increased (x2=113.715,P＜0.001; rs=7.19,P＜0.001).The ROC area under the curve of 0.882 (standard error 0.005,95％CI:0.873-0.891,P＜0.001) was significant in predicting neonatal hyperbilirubinemia by cord blood bilirubin,and the occurrence of hyperbilirubinemia increased with increasing cord blood bilirubin level.Neonatal cord blood total bilirubin ≥ 50 μ mol/L predicted hyperbilirubinemia,and the positive predictive value was 0.683,negative predictive value was 0.959,sensitivity was 0.690 and specificity was 0.958.Conclusions Cord blood bilirubin level is useful in predicting subsequent neonatal hyperbilirubinemia in term infants with ABO hemolytic disease.
