【摘要】 目的　通过收集我国较大范围的母乳喂养正常新生足月儿生理性黄疸的调查资料 ,得出我国部分地区正常新生儿黄疸胆红素的峰值和平均值 ,为临床诊断奠定基础。方法　采取统一课题设计 ,多中心协作的方法 ,对 875例正常足月新生儿自生后第 1天 (2 4h内 )开始每天分别取微量血和经皮测胆红素者 ,监测至胆红素水平相当于 6 8.4μmol/L以下。对其中血清胆红素峰值大于 2 2 0 .5μmol/L的 5 6例 ,做脑干听力诱发电位的测定。 结果　 (1)正常足月新生儿生后第 2～ 3天开始出现黄疸 ,第 5天达高峰 ,平均峰值为 (2 0 4± 5 5 ) μmol/L。血清胆红素峰值超过 2 2 0 .5 μmol/L者占 34 .4%。(2 )不同地区 (P <0 .0 1)及不同季节 (P <0 .0 5 )出生的新生儿血清胆红素值差异有显著性。 (3)在围产因素中 ,新生儿早期的胆红素水平与胎龄 (P <0 .0 1)、分娩方式 (P <0 .0 1)、出生 1～ 3d的生理性体重下降 (P <0 .0 0 1)及红细胞压积水平 (P <0 .0 0 1)差异有显著性。结论　正常足月新生儿黄疸出现的时间与国内外其他报道相似 ,但平均峰值高于既往报道的局部人群的峰值 ,更明显高于西方国家的新生儿。血清胆红素峰值超过 2 2 0 .5 μmol/L者占 34 .4%。 5 6例血清胆红素超过 2 2 0 .5 μmol/L的正常足月新生儿的脑干听力?更多还原

【Abstract】 Objective To provide an epidemiological data for revising the diagnostic criterion of neonatal hyperbilirubinemia in China. Methods The survey was performed among the normal full term infants in the multi center over the country. From less than 24 hours of age the infants’ bilirubin levels were measured every day and until the peak level of the bilirubin fell to less than 68.4 μmol/L. Auditory brainstom responses were assessed for infants whose serum bilirubin levels were higher than 220.5 μmol/L in 56 neonates. Results Jaundice was detected in 2 3 days of age for most infants. The bilirubin level usually reached to a peak level of 204±55 μmol/L at 5 days of age and then fell down. Among 875 infants, the serum bilirubin levels in 34.4% of neonates were higher than 220.5 μmol/L. The mean serum bilirubin level of infants at age 1 7 days varied with geographic locations (P<0.01) and different seasons (P<0.05). The serum bilirubin level was significantly associated with gestation ages (P<0.01),delivery mothods (P<0.01), weight losses (P<0.001), and PCV elevations (P<0.001) in the first three days of birth, and so on. Conclusions The beginning time of normal neonatal jaundice was similar to the published reports of national and overseas, but the mean peak level was higher than that of local area and western countries. It suggested that the diagnostic criterion of neonatal hyperbilirubinemia in China should be strict.更多还原