【摘要】

目的：分析蓝光辐照度在新生儿高胆红素血症蓝光治疗疗效评估中的作用。
方法：将2013年06月至2014年5月因高胆红素血症收住我院的符合纳入标准的足月新生儿随机分为新蓝光组、部分蓝光组及旧蓝光组，分别应用不同使用时间的蓝光灯予以光照治疗，观察治疗前后TSB下降情况及其与光辐照度之间的相关性。
结果：各组患儿临床特征及治疗前TSB无明显差异 [17.9 (15.8, 18.9) vs 17.8 (15.8，18.6) vs 17.9 (15.7，18.9) mg/dl, z = 3.239, P = 0.198]， 经过蓝光治疗后血清TSB水平均有下降，三组TSB水平呈递增状态[8.6 ( 7.9，9.3) vs 10.6 (9.2，11.5) vs 11.8 (11.2，12.6) mg/dl, z =44.796, P=0.000]。三组光辐照度随使用时间延长而逐渐下降（30.2±2.0 vs 24.3±2.8 vs 18.1±1.9，F=202.872, P<0.001）。相关分析显示TSB下降的水平（△TSB）与光辐照度呈明显正相关（r=0.846，p=0.000）。
结论：蓝光治疗的疗效与光辐照度关系较大，使用时间越长的蓝光灯光辐照度下降，治疗效果下降。因此，应用蓝光辐照计对使用一定时间的蓝光灯进行辐照度测定，及时更换灯管，提高治疗效果。

【Abstract】

Objective: to evaluate the relationship of irradiation and the treatment effect of phototherapy in infants with hyperbilirubinemia.
Methods: Term infants admitted in our hospital because of hyperbilirubinmia during June 2013 to May 2013. Infants fitting entry criteria were enrolled into this study and randomly divided into three group：fully new blue ray，partly new blue ray and old blue ray. Total serum bilirubin (TSB) was detected before and after treatment. The correlation between light irradiance and the decreasing extent of TSB (delta TSB) was analyzed.
Results: No difference of clinical characteristics was shown among these three groups before treatment, as well the TSB level before phototherapy [17.9 (15.8, 18.9) vs 17.8 (15.8，18.6) vs 17.9 (15.7，18.9) mg/dl, z = 3.239, P = 0.198]. After phototherapy, TSB showed decreasing in all infants while there was a gradually increasing trend among the groups [8.6 ( 7.9，9.3) vs 10.6(9.2，11.5) vs 11.8 (11.2，12.6) mg/dl, z =44.796, P=0.000]. The irradiance gradually decreased with the using of the light among the groups（30.2±2.0 vs 24.3±2.8 vs 18.1±1.9μW·cm-2 ·nm-1，F=202.872, P<0.001）. Correlation analysis showed there was a significant positive correlation between delta TSB and light irradiance（r=0.846，p=0.000）.
Conclusion  : The effect of blue light has a great relationship with light irradiance. Irradiance and the treatment effect fell with the using of the light. Therefore, the blue light irradiance could be used for the irradiance measurement of blue light. Replacement timely of the light may improve the treatment effect.