- 期刊
Clinical Evaluation of Transcutaneous Jaundice Meter in Full-Term Newborns
經皮膚黃疸測定器在足月新生兒之臨床應用評估
摘要
爲了檢定經皮膚黃疸側定器指數與血清膽紅素值，在新生兒身體上不同部位及出生後不同天數時之相關性，及利用行動水平值(action level)以篩檢新生兒膽紅素過高症之正確性，著者等對98位足月、健康、尚未照光治療之新生兒，在測血清值之同時亦用黃疸器測定指數，計有178對數值加以分析。結果顯示血清值與黃疸器指數間呈現有意義之單純線性相關，其中以前額部位之相關係數(r=0.87)及判定係數(r^2=0.76)最佳。在身體上不同部位測得之線性相關之斜率由頭向脚方向遞减，顯示新生兒黃疸由頭向脚方向進行之趨勢。在前額測得之黃疸器指數在出生後不同天數時和血清膽紅素值間呈現有意義且持續性之相關性。 以血清值10及13mg/dl求得之相對黃疸器指數為15及16。即當黃疸器指數大於16時，須同時抽血追蹤血清值；小於15時，可以黃疸器複檢而暫不必抽血；等於15或16時，需密切觀察及複檢，視臨床狀况决定是否需抽血檢查。以大於行動水平值16為陽性來檢定血清值大於或等於13mg/dl時之正確性為敏感度90%，特異度90%，陽性預側值54%，陰性預測值99%。 經皮膚黃疸測定器可做爲臨床上診治新生兒黃疸之輔助及篩檢儀器。其操作簡單、快速、正確、無侵襲性，並可依行動水平值之參考减少非必要抽血之頻率。但因各實驗室問血清值之變異及各黃疸器間之差異，各單位在使用前需先評估二者之相關性及側定行動水平值。
關鍵字
無資料並列摘要
Serum bilirubin (SB) and jaundice meter index (JMI) were evaluated at eight different body sites in 98 full-term newborns within their first seven days of life. There was a linear correlation between JMI and SB. The forehead area had the highest correlation (0.87) and determination coefficients (0.76). The slope of the linear regression line decreased progressively from forehead to sole, an indication of the cephalopedal progression of dermal icterus. The correlation was compatible on different postnatal days. The JMI corresponded to SB of 10mg/dl and 13mg/dl were 15 and 16, respectively. This meant that when JMI was less than 15, no SB determination was needed; at greater than 16, SB measurement was indicated; at 15 or 16, the infant should be observed, with indication for SB measurement by serial JMI data and by clinical judgement. Using an action level of 16 to predict SB of 13mg/dl or more, the sensitivity was 90%; specificity, 90%; negative predictive value, 99%; positive predictive value, 54%. The correlation of JMI to SB should be assessed before clinical usage of the transcutaneous jaundice meter as a screening device for neonatal jaundice.