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中国循证儿科杂志

中国循证儿科杂志 ›› 2018, Vol. 13 ›› Issue (3): 166-169.

• 论著 • 上一篇    下一篇

微量血气分析仪检测新生儿血清胆红素水平的可靠性分析

黄循斌1,3,刘露2,3,曾淑娟1,丘惠娴1,程国强2   

  1. 1 广东省深圳市龙岗中心医院深圳，518116；2 复旦大学附属儿科医院新生儿科上海，201102；3 共同第一作者
  • 收稿日期:2018-03-02 修回日期:2018-06-25 出版日期:2018-06-24 发布日期:2018-06-25
  • 通讯作者: 丘惠娴，程国强

The reliability analysis of serum bilirubin in newborns measured with the blood gas analyzer

HUANG Xun-bin 1,3, LIU Lu 2,3, ZENG Shu-juan 1, QIU Hui-xian1, CHENG Guo-qiang2#br#   

  1. 1 Longgang District Central Hospital of Shenzhen, Shenzhen 518116,China; 2 Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China; 3. Co-first author
  • Received:2018-03-02 Revised:2018-06-25 Online:2018-06-24 Published:2018-06-25
  • Contact: QIU Hui-xian,Cheng Guoqiang

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摘要： 目的：分析微量血气分析仪和全自动生化分析仪检测新生儿血清总胆红素（TBil）值的相关性和一致性。方法：回顾性纳入复旦大学附属儿科医院新生儿科入院时间在2017年12月1日至2018年1月31日的患儿入院当日首次同步使用微量血气分析仪和全自动生化分析仪检测的血清TBil值，采用Spearman相关系数和Bland-Altman散点图分析两种方法TBil检测值的相关性和一致性。结果：①共纳入123例患儿，全自动生化分析仪的TBil检测值为（292.6±113.4）μmol·L-1，其中TBil＜200、~300、~400和>400 μmol·L-1的患儿分别为32、33、35和23例；微量血气分析仪对应的TBil检测值均低于全自动生化分析仪 ( P＜0.001)。②在123例以及全自动生化分析仪TBil检测值在＜200、~300、~400和>400 μmol·L-1的患儿中，两种检测方法TBil检测值的相关系数分别为0.98、0.88、0.81、0.78和0.88，P＜0.001；平均偏倚分别为（30.9±25.6）、（15±12.5）、（23±18.3）、（39±28.3）和（52±25.3）μmol·L-1，95% CI分别为 -19.2~81.0、-9.5~39.6、-12.9~58.9、-16.5~94.5和2.3~101.7 μmol·L-1，TBil值在95%CI以外者分别占4%（5/123）、9%（3/32）、3%（1/33）、3%（1/35）和4%（1/23）。结论：微量血气分析仪与全自动生化分析仪测定的胆红素值线性相关性较好，但一致性较差，故微量血气分析仪仅可作为全自动生化分析仪检测TBil值的补充。

Abstract: Objective: To analyze the correlation and consistency of total bilirubin (TBil) values in newborns measured with blood gas analyzer and automatic biochemical analyzer. Methods: The infants admitted to Neonatal Department of Children's Hospital of Fudan University from December 1st 2017 to January 31st 2018 were enrolled，and on the first day of admission，TBil values were measured for the first time using blood gas analyzer and automatic biochemical analyzer simultaneously. Spearman's correlation coefficients and blandAltman plots were used to analyze the correlation and consistency of TBil values measured with both methods. Results:① A total of 123 infants were included. The TBil value measured with the automatic biochemical analyzer was 292.6±113.4 μmol·L-1, and the infants with TBil＜200, ~300, ~400 and >400 μmol·L-1 were 32, 33, 35 and 23 cases respectively. Compared with automatic biochemical analyzer, mean TBil values measured with the blood gas analyzer were lower (P＜0.001), whether in the total 123 cases or in subgroups with different TBil values.② Correlation coefficients of TBil of 123 infants and infants with TBil＜200, ~300, ~400 and >400 μmol·L-1 measured with the blood gas analyzer were 0.98, 0.88, 0.81, 0.78 and 0.88 respectively, P＜0.001. The overall biases were 30.9±25.6, 15.0±12.5, 23.0±18.3, 39.0±28.3 and 52.0±25.3 μmol·L-1 respectively; 95%CI were -19.2~81.0, -9.5~39.6, -12.9~58.9, -16.5~94.5 and 2.3~101.7 μmol·L-1 respectively; TBil values outside the 95%CI respectively accounted for 4% (5/123), 9% (3/32), 3% (1/33), 3% (1/35) and 4% (1/23). Conclusion: The values of TBil measured by blood gas analyzer have good linear correlation with the automatic biochemical analyzer, but the consistency is poor. Therefore, blood gas analyzer may only be used as an important supplement for the determination of TBil values measured with the automatic biochemical analyzer.