新生儿总胆红素与白蛋白比值对预测胆红素神经毒性的临床意义  

Significance of total bilirubin/albumin in predicting bilirubin neurotoxicity

作　　者：陈清[1] 苏卫东[1] 瞿尔力[1] 黄育丹[1] 邓秀睿[1] 

机构地区：[1]温州医学院定理临床学院暨温州市第二人民医院新生儿科,325000

出　　处：《中国医师进修杂志》2011年第21期7-9,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨新生儿血清总胆红素／白蛋白在预测胆红素神经毒性方面的临床意义。方法选择2007年5月至2010年8月住院治疗的高胆红素血症新生儿83例，检测其血清总胆红素和白蛋白等，并计算血清总胆红素／白蛋白，同时根据脑干听觉诱发电位（BAEP）的检测结果分为BAEP正常组和BAEP异常组，并对比观察。结果BAEP异常组27例，BAEP正常组56例，BAEP异常组的血清总胆红素、血清总胆红素／白蛋白均显著高于BAEP正常组[（356．50±59．23）μmol／L比（318．70±55．12）μmol/L、（5．02±0．49）×10^-3比（4．56±0．43）×10^-3]，差异有统计学意义（P〈0．05）；多元回归分析显示：BAEP异常与血清总胆红素／白蛋白密切相关（r=0．72，P〈0．05），而与血清总胆红素无明显相关性（r=0．19，P〉0．05）。结论血清总胆红素／白蛋白较血清总胆红素更能反映高胆红素血症新生儿血中游离胆红素的水平，可作为评估胆红素神经毒性危险因素的指标之一。Objective To investigate the significance of total bilirubin/albumin in predicting bilirubin neurotoxicity. Methods Eighty-three cases with hyperbilirubinemia who treated from May 2007 to August 2010 were selected, the serum total bilirubin and albumin were detected and total bilirubin/albumin was calculated. According to brainstem auditory evoked potential （BAEP） results,the patients were divided into normal BAEP group and abnormal BAEP group and compared. Results There were 27 cases of abnormal BAEP group and 56 cases of normal BAEP group. Total bilirubin and total bilirubin/albumin in abnormal BAEP group were higher than those in normal BAEP group [ （356.50 ± 59.23）μmol/L vs. （318.70±55.12） μ mol/L, （5.02 ±0.49） × 10^-3 vs. （4.56 ±0.43） ×10^-3 ], the differences were significant （P 〈 0.05）. Multiple regression analysis showed： abnormal BAEP was closely related to total bilirubin/ albumin（r = 0.72,P〈 0.05 ）, while abnormal BAEP was not obviously related to total bilirubin（r = 0.19 ,P 〉 0.05 ）. Conclusion Total bilirubin/albumin can reflect serum unconjugated bilirubin level of neonatus with hyperbilirubinemia better than total bilirubin, and it can be taken as one index to evaluate the risk factors of bilirubin neuretoxicity.

关 键 词：婴儿 新生 诱发电位 听觉 脑干 血清白蛋白 总胆红素 胆红素神经毒性 

分 类 号：R722.1[医药卫生—儿科]