[1]范礼英,冯彬彬,李 婷,等.呼气末一氧化碳测定对新生儿溶血病的诊断价值[J].医学信息,2023,36(10):68-70.[doi:10.3969/j.issn.1006-1959.2023.10.016]
　FAN Li-ying,FENG Bin-bin,LI Ting,et al.Diagnostic Value of End-tidal Carbon Monoxide in Hemolytic Disease of Newborn[J].Journal of Medical Information,2023,36(10):68-70.[doi:10.3969/j.issn.1006-1959.2023.10.016]
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呼气末一氧化碳测定对新生儿溶血病的诊断价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年10期
页码:
68-70
栏目:
论著
出版日期:
2023-05-15

文章信息/Info

Title:
Diagnostic Value of End-tidal Carbon Monoxide in Hemolytic Disease of Newborn
文章编号:
1006-1959（2023）10-0068-03
作者:
范礼英; 冯彬彬; 李 婷; 等
（湖南省妇幼保健院新生儿科，湖南 长沙 410000）
Author(s):
FAN Li-ying; FENG Bin-bin; LI Ting; et al.
(Department of Neonatology,Hunan Provincial Maternal and Child Care Hospital,Changsha 410000,Hunan,China)
关键词:
内源性一氧化碳 ; 呼气末一氧化碳含量; 新生儿溶血病
Keywords:
Endogenous carbon monoxide; End-expiratory carbon monoxide content; Hemolytic disease of newborn
分类号:
R722.18
DOI:
10.3969/j.issn.1006-1959.2023.10.016
文献标志码:
A
摘要:
目的 通过测定碳氧血红蛋白（COHb）和呼气末一氧化碳（ETCOc）水平，早期识别处于溶血性高胆红素血症风险的新生儿。方法 回顾性分析2021年5月-9月本院新生儿科收治的新生儿高胆红素血症（黄疸值Bhutani95%以上）60例作为研究对象，根据溶血全套结果分为溶血组（36例）与非溶血组（24例）。两组均在采血后1 h内进行ETCOc检测。分析患儿一般情况、ETCOc、COHb、血红蛋白（HB）、网织红细胞（Ret）及总胆红素值（STB）。结果 36例患儿确诊ABO溶血病、24例患儿为非溶血性高胆红素血症，两组STB比较，差异无统计学意义（P＞0.05）；溶血组Ret高于非溶血组，Hb低于非溶血组，但差异无统计学意义（P＞0.05）；溶血组COHb、ETCOc值高于非溶血组，差异有统计学意义（P＜0.05）；COHb、ETCO的AUC分别为61.10%、74.30%（P＜0.05），ETCOc最佳截断值为2.15 ppm。结论 与Ret、Hb溶血指标相比，ETCOc测定可作为新生儿溶血病早期筛查指标。
Abstract:
Objective To identify neonates at risk of hemolytic hyperbilirubinemia by measuring the levels of carboxy-hemoglobin (COHb) and end-tidal carbon monoxide (ETCOc).Methods A retrospective analysis of 60 cases of neonatal hyperbilirubinemia (jaundice value Bhutani 95% or more ) admitted to the neonatal department of our hospital from May to September 2021 was conducted. According to the results of hemolysis, they were divided into hemolysis group (36 cases) and non-hemolysis group (24 cases). ETCOc detection was performed within 1 h after blood collection in both groups. The general condition, ETCOc, COHb, hemoglobin (HB), reticulocyte (Ret) and total bilirubin (STB) were analyzed.Results Of 36 children were diagnosed with ABO hemolytic disease and 24 children were diagnosed with non-hemolytic hyperbilirubinemia. There was no significant difference in STB between the two groups (P>0.05). Ret in hemolytic group was higher than that in non-hemolytic group, and Hb was lower than that in non-hemolytic group, but the difference was not statistically significant (P>0.05). The values of COHb and ETCOc in the hemolytic group were higher than those in the non-hemolytic group (P<0.05). The AUC of COHb and ETCO were 61.10% and 74.30%, respectively (P<0.05), and the optimal cutoff value of ETCOc was 2.15 ppm. Conclusion Compared with Ret and Hb hemolysis indexes, ETCOc determination can be used as an early screening index for neonatal hemolytic disease.

参考文献/References:

[1]Bhutani VK,Wong R.Bilirubin-induced neurologic dysfunction (BIND)[J].Semin Fetal Neonatal Med,2015,20(1):1.[2]邵晓梅,叶鸿瑁,丘小汕.实用新生儿学[M].第5版.北京:人民卫生出版社,2019:446-451.[3]Kaplan M,Bromiker R,Hammerman C.Hyperbilirubinemia, hemolysis, and increased bilirubin neurotoxicity[J].Semin Perinatol,2014,38(7):429-437.[4]Christensen RD,Yaish HM,Wiedmeier SE,et al.Neonatal death suspected to be from sepsis was found to be kernicterus with G6PD defi- ciency[J].Pediatrics,2013,132(6):e1694-e1698.[5]中华医学会儿科学分会新生儿学组,《中华儿科杂志》编辑委员.新生儿高胆红素血症诊断和治疗专家共识[J].中华儿科杂志,2014,52(10):745-748[6]Christensen RD,Malleske DT,Lambert DK,et al.Measuring End-Tidal Carbon Monoxide of Jaundiced Neonates in the Birth Hospital to Identify Those with Hemolysis[J].Neonatology,2016,109(1):1-5.[7]Christensen RD,Lambert DK,Henry E,et al.End-tidal carbon monoxide as an indicator of the hemolytic rate[J].Blood Cells Mol Dis,2015,54(3):292-296.[8]邹佩佩.内源性一氧化碳对新生儿溶血病的诊断价值[D].杭州:浙江大学,2013.[9]宋琳,童笑梅.呼末一氧化碳对新生儿溶血病的诊断价值[J].国际儿科学杂,2018,45(6):438-441[10]Beken S,Hirfanoglu I,Turkyilmaz C,et al.Intravenous Immunoglobulin G Treatment in ABO Hemolytic Disease of the Newborn, is it Myth or Real?[J].Indian J Hematol Blo,2014,30(1):12-15.[11]Doyle B,Quigley J,Lambert M,et al.A correlation between severe haemolytic disease of the fetus and newborn and maternal ABO blood group[J].Transfusion Medicine,2014,24(4):239-243.[12]White J,Qureshi H,Massey E,et al.Guideline for blood grouping and red cell Antibody testing in pregnancy[J].TransfusMed,2016,26(4):246-263.[13]王琦.溶血患儿与非溶血患儿COHb、参数的变化观察[J].实验与检验医学,2018,36(3):431-433.[14]杨爱娟,李磊,王艳维,等.碳氧血红蛋白在新生儿ABO溶血病诊断中的价值[J].中国妇幼健康研究,2017,28(2):121-124.[15]Tidmarsh GF,Wong RJ,Stevenson DK.End-tidal carbon monoxide and hemolysis[J].Perinatol,2014,34(8):577-581.[16]Bhutani VK,Maisels MJ,Schutzman DL,et al.Identification of risk for neonatal haemolysis[J].Acta Paediatr,2018,107(8):1350-1356.

更新日期/Last Update: 1900-01-01