摘要目的 通过收集全国较大范围内母乳喂养新生儿生理性黄疸的调查资料，得出我国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例足月新生儿自生后第1天（24小时内）开始每天监测胆红素水平直至血清胆红素峰值达68.4 μmol/L以下。对其中56例血清胆红素峰值大于220.5 μmol/L者做脑干听力诱发电位的测定。 结果 （1）足月新生儿出生后第2-3天开始出现黄疸，第5天达高峰，平均峰值为204±54.69 μmol/L。血清胆红素峰值超过220.5 μmol/L者占34.4％。（2）不同地区（P<0.01）及不同季节(P<0.05)出生的新生儿其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<0.01)、分娩方式(P<0.01)、出生后1-3天的生理性体重下降(P<0.001)及红细胞压积水平(P<0.001)密切相关。 结论 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220.5 μmol/L者占34.4％。56例血清胆红素超过220.5 μmol/L的足月新生儿的脑干听力诱发电位无异常发现。提示新生儿高胆红素血症的诊断标准应高于现行标准,因而高胆红素血症的干预标准也应相应提高。

abstractsObjective To provide epidemiological data for revising thediagnostic criteria of neonatal hyperbilirubinemia in China. Methods A survey was performed among full-term infants in multiple centers throughout the country. From less than 24 hours after birth, the infants' bilirubin levels were measured every day until the peak level fell to less than 68.4 μmol/L. Auditory brainstem responses were assessed in 56 infants randomly chosen from those with serum bilirubin levels of higher than 220.5 μmol/L. Results Jaundice in most infants was detected at 2-3 days after birth. The bilirubin level usually reached a peak level of 204±54.69 μmol/L at 5 days after birth and then fell. Among the 875 infants, the serum bilirubin levels in 34.4% of neonates were higher than 220.5 μmol/L. The mean serum bilirubin level of the infants during the first week after birth varied with geography (P<0.001) and season (P<0.001). The serum bilirubin level was significantly associated with gestation age (P<0.01), delivery method (P<0.01), weight loss (P<0.001), and PCV elevation (P<0.001) during the first three days after birth. Conclusions The start time of neonatal jaundice was similar to that reported elsewhere, but the mean peak level in our study was higher than the reported. It is suggested that the diagnostic criteria for neonatal hyperbilirubinemia in China should be strict.