血液生化指标对早产儿脏器成熟度的多元线性回归分析  

Multiple linear regression and clinical analysis of serum biochemical markers on organ maturation in premature infants.

作　　者：刘长云[1] 孙春燕[1] 王永芹[1] 季加芬[1] 马红美[1] 毕英秀[1] 辛毅[1] 

机构地区：[1]山东省潍坊市潍坊医学院附属医院儿科,潍坊市261031

出　　处：《中华妇幼临床医学杂志（电子版）》2006年第5期260-263,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：山东省潍坊市科技局项目(编号:2003A1CB8)

摘　　要：[目的]采用多元线性回归分析不同胎龄和体重早产儿心脏、肝、肾等生化指标与各脏器成熟度的关系,了解和分析早产儿的脏器成熟情况,为临床诊治提供理论依据。方法选择2004年8月至2005年10月潍坊医学院附属医院儿科住院新生儿病例,分别按不同胎龄分为3组、按出生体重分为4组,各组间性别、Apgar评分、分娩方式经统计学检验,差异无显著意义(P>0.05)。所有对象均于生后24h内自股静脉采血2ml,制备血清样本,-20℃冷冻保存,采用AU600生化分析仪进行检测,比色法测定血清总胆红素及间接胆红素,国际标准酶法测定丙氨酸氨基转移酶,溴甲酚绿终点法测定白蛋白,循环酶法测定总胆汁酸,Urease-GLDH法测定尿素氮,苦味酸法测定肌苷,抗体抑制法测定肌酸激酶心型同工酶。所有数据用均数±标准差(-x±s)表示,采用SPSS13.0统计软件进行方差分析和SNK-q检验,以及多元线性回归分析。结果按胎龄分组,随着胎龄增加,血清白蛋白、直接胆红素与总胆红素比值增高,总胆汁酸、尿素氮减少,F值分别为120.97,359.15,312.69,327.62(P<0.05)。胎龄与生化指标作多元线性回归分析,差异有显著意义(F=3086.9,P<0.01),与胎龄密切程度排序依次为总胆汁酸、尿素氮、直接胆红素与总胆红素比值、白蛋白;体重与生化指标作多元线性回归分析,差异有显著意义(F=527.786,P<0.01)。结论与胎龄关系密切的生化指标依次为胆汁酸、尿素氮、直接胆红素与间接胆红素的比值、血清白蛋白;与体重关系密切的指标为血清白蛋白。血清白蛋白、总胆汁酸、直接胆红素与间接胆红素的比值与尿素氮可分别作为评价早产儿肝、肾成熟度的指标;而肌酸激酶心型同工酶,则不能评价早产儿心脏成熟度。Objective By multiple linear regression to investigate the serum biochemical markers which can examine organ maturation of cardiac, liver, renal, and provide the oretical evidence to revise therapy protocol on evaluation of organ maturation in premature infants. Methods 100 premature infants hospitalized at department of pediatrics affiliated to Weifang medical college were selected during 2004-08 to 2005-10. All infants were divided into three groups according to gestational age. Four groups were divided according to birth weight （BW）. The sex, Apgar scores and type of delivery were no statistical difference among all groups. The serum samples were prepared with intrave in blood and crypreserved at 24 h after birth. Total bilirybin （TBIL）, direct bilirubin （DBIL）, alanine aminotrasferrase （ALT）, albumin （ALB）, total bile acid（TBA）, blood urea nitrogen（BUN）, serum carnine （SCr）, serum creation kinase isozyme B （CK-MB） were determined by AU600 biochemical analyzer and conducted analysis of variance and multiple linear regression among all groups using SPSS 13.0 software. Results Significance difference were found in ALB, D/I, TBA, BUN among group Ⅰ～Ⅱ, ALB, I/D were increased and TBA, BUN were decreased with GA （F was 120. 97,359. 15, 312. 69, 327. 62,P〈0. 05. standardized regression coefficients were 0. 064,0. 236,0. 675,0. 592,respectively）, the difference was significantly（F= 3086. 9,P〈0. 01）, the degree of relationship to GA was TB, BUN, BUN, D/I, ALB; BW （g）=- 4. 768 ＋ 0. 184 ALB,standardized regression coefficient was 0.881, significance difference was found （F =527. 786, P〈0. 01）. Conelusion Multiple linear regression model was built about serum biochemical markers to GA and BW. The serum biochemical markers which has close relationship to GA gradually is TBA, BUN, D/I, ALB; The serum biochemical markers which has close relationship to BW is ALB. Our findings confirm that ALB, D/I,TBA, BUN can examine maturation of liver, kidney in premature i

关 键 词：早产儿 血液生化指标 成熟度 多元线性回归 

分 类 号：R722.6[医药卫生—儿科]