Kernicterus: epidemiological strategies for its prevention through systems-based approaches.
Kernicterus: epidemiological strategies for its prevention through systems-based approaches.
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DOI：
10.1038/sj.jp.7211152
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发表时间：
2004-10-01
期刊：
影响因子：
--
通讯作者：
Yeargin-Allsopp, Marshalyn
中科院分区：
文献类型：
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作者：
Bhutani, Vinod K;Johnson, Lois H;Yeargin-Allsopp, Marshalyn
核黄疸被认为是由严重的高胆红素血症引起的，是一种罕见的疾病，会带来悲惨的后果，特别是当它影响健康足月和近足月婴儿时。早期识别、预防和治疗严重高胆红素血症应使核黄疸成为可预防的疾病。然而，需要国家流行病学数据来监测任何预防策略。建议使用标准化定义获取有关严重高胆红素血症的患病率和发病率以及相关死亡率和神经损伤的前瞻性数据，探索核黄疸试点登记中确定的儿童核黄疸的临床特征和根本原因，确定和测试人群监测指标，验证基于系统的新生儿黄疸管理方法，并探索使用生物或遗传标记来识别高胆红素血症风险婴儿的可行性。增加对严重高胆红素血症的发生率和后果的了解对于干预措施的规划、实施和评估至关重要，以确保从出生医院健康出院的婴儿能够更安全地回家，避免因高胆红素血症和其他疾病而发病。在最近由 NIHCD 主办的一次会议上，提出了有关核黄疸以及需要采取其他预防策略的关键问题。这些问题及其解答方法构成了本报告的基础。
Kernicterus, thought to be due to severe hyperbilirubinemia, is an uncommon disorder with tragic consequences, especially when it affects healthy term and near-term infants. Early identification, prevention and treatment of severe hyperbilirubinemia should make kernicterus a preventable disease. However, national epidemiologic data are needed to monitor any preventive strategies. Recommendations are provided to obtain prospective data on the prevalence and incidence of severe hyperbilirubinemia and associate mortality and neurologic injury using standardized definitions, explore the clinical characteristics and root causes of kernicterus in children identified in the Kernicterus Pilot Registry, identify and test an indicator for population surveillance, validating systems-based approaches to the management of newborn jaundice, and explore the feasibility of using biologic or genetic markers to identify infants at risk for hyperbilirubinemia. Increased knowledge about the incidence and consequences of severe hyperbilirubinemia is essential to the planning, implementation and assessment of interventions to ensure that infants discharged as healthy from their birth hospitals have a safer transition to home, avoiding morbidity due to hyperbilirubinemia and other disorders. At a recent NIHCD-sponsored conference, key questions were raised about kernicterus and the need for additional strategies for its prevention. These questions and an approach to their answers form the basis of this report.