高胆红素血症对新生儿神经行为影响的探讨  

The Influence of Neonatal Hyperbilirubinemia on Neonatal Behavior

作　　者：汪晓阳[1] 唐泽媛[1] 姚裕家[1] 唐爱丽[1] 

机构地区：[1]华西医科大学附属第二医院儿科

出　　处：《华西医科大学学报》1993年第1期67-70,共4页Journal of West China University of Medical Sciences

摘　　要：用NBAS_(20)项对新生儿高胆红素血症病婴的神经行为进行评估测定,结果显示高胆红素血症对新生儿行为能力、运动能力及神经反射均有影响,其中以视听定向力及肌张力方面的影响为著。血清胆红素≥205μmol/L时,胆红素水平与行为能力评分呈直线负相关关系。(r=-0.53,P<0.001)新生儿神经行为测定可以全面地估价新生儿中枢神经系统的发育状况,有助于早期发现新生儿中枢神统系统的轻微功能障碍。Two groups of neonates, 30cases with hyperbilirubinemia (307.8±99.86μmol/L) and 30 normal newborns(control group with bilirubin 80.37±35.74μmol/L), were evaluated with NeonatalBehavioral Assessment Scale (NBAS)and followed up at the age of 2 monthsand 5 months. All cases in the twogroups were evaluated with NBAS at agesof 2-3 days, 12-14 days and 26-28 days.The results showed that there were statis-tically significant differences betweenthe two groups in the aspects of attentionand social responsiveness, the ability tomodulate state of consciousness, themotor integrity and the reflexes. We alsofound that while the level of bilirubin wasbelow 205.2μmol/L, there was no corre-lation between the level of bilirubin andNBAS (r=-0.095, P>0.02), but when bi-lirubin was at or above the level of 205.2μmol/L, there was significant negativecorrelation (r=-0. 53, P<0.001) betweenthe two. The follow-up revealed that 9 of23 jaundiced infants had abnormal audi-tory reactions or abnormal muscle tonusat the age of 2 months; 8 of the 9 infantsrecovered, but 1 still had abnormal mu-scle tonus by the age of 5 months. Thestudy suggests that hyperbilirubinemiaabove the level of 205.2μmol/L would af-fect neonatal behavior and the greater theseverity of jaundice, the more significantthe influence on neonatal behavior. Theeffects on some jaundiced infants maylast 5 months or more. NBAS is a valua-ble scale for early detection of mild braindysfunctions which are less obvious onclinical examination.

关 键 词：高胆红素血症 新生儿 

分 类 号：R722.15[医药卫生—儿科]