动静_____新生儿；胆红素；换血；回归分析

外周动静脉同步换血的换血量与胆红素水平关系的探讨

http://www.100md.com 《中国热带医学杂志》 2005年第2期

动静,,新生儿；胆红素；换血；回归分析,1资料与方法,2结果,3讨论,参考文献：

     摘要：目的探讨高胆红素血症外周动静脉同步换血的换血量与总胆红素(TSB)下降的关系。方法对15例高胆红素血症患儿采用外周动静脉同步换血，换血前及每换血50ml/kg进行TSB检测。结果高胆红素血症患儿每换血50ml/kg前后血清总胆红素的对比均有显著降低(P<0001)；每换血50 ml/kg前后总胆红素TSB的平均换出率在20%～23%之间，前后的差异性对比无显著意义(P>05)；每换血50 ml/kg前后总胆红素TSB的累积换出率的差异性对比有显著意义(P<001)；在换血150 ml/kg后总胆红素TSB的累积换出率为5162%±368%。结论换血量(X)与总胆红素浓度下降(Y)呈高度线性相关关系，线性回归方程为Y＝Y0-160X，适用范围为Y0＝385～452μmol/L；相关系数r＝-09914, 回归决定系数R2＝09828；在回归参数在95%水平时的置信区间内，可根据回归方程可预测推算所需要的换血量或换血后胆红素的水平。

    关键词：新生儿；胆红素；换血；回归分析

    中图分类号：R72217 文献标识码：A 文章编号：1009-9727(2005)02-224-03

    Discussion on the relationship between quantity of peripheral venous blood synchronizingly changed and the bilirubin level LIN Jing,MING Jing (Hainan Provincial People’s Hospital , Haikou 570311, Hainan, P R China)

    Abstract：Objective To study the relationship between the decrease of TSB volume and the exchange transfusion volume via peripheral vessels in the case of hyperbilirubinaemia Methods Perform exchange transfusion on 15 newly born infants with hyperbilirubinaemia,and detect the level of their TSB volume before the exchange transfusion and after every 50 ml/kg exchanged Results For infants with hyperbilirubinaemia,there is a significant decrease in both serum and TSB level after the exchange transfusion with P<0001 The average clearance rate of TSB varies between 20% and 23%,and the comparison on diversity is of no great significance with P<005 While the diversity comparison of the accumulative clearance rate of TSB after every exchanged per 50ml/kg is very significant with P<001 The accumulative clearance rate of TSB is about 5162%±368% after 150ml/kg exchanged Conclusion The exchange transfusion volume (X) is in linear relationship with the decrease of TSB volume (Y) The linear regression equation Y=Y0-160X is applicable when Y0=385～452μmol/L The relevant coefficient is r=-09914,and the decisive regression coefficient is R2=09828 When the regression parameter ranges within 95% of its confidence interval,the exchange transfusion volume needed and the bilirubin level after the exchange transfusion can be calculated according to the regression equation ......

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