高胆红素血症新生儿脑脊液胆红素检测的临床应用价值探讨  

Clinical application value of bilirubin detection in cerebrospinal fluid of neonates with hyperbilirubinemia

作　　者：周柏林 王全震 吕清秀 董静[2] 

机构地区：[1]湖南省湘潭县人民医院新生儿科,411228 [2]湖南省儿童医院儿科研究所博士后工作站

出　　处：《中国妇幼保健》2013年第17期2728-2730,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨脑脊液中未结合胆红素检测在高胆红素血症新生儿中的临床应用价值。方法:对285例高胆红素血症新生儿的脑脊液和血液未结合胆红素水平进行检测,计算未结合胆红素/白蛋白比值(B/A),并进行新生儿行为神经评分(NBNA)。结果:警告期和痉挛期的胆红素脑病新生儿血中未结合胆红素(UCB)、脑脊液(CSF)中UCB和血B/A比值均明显高于单纯高胆红素血症的新生儿,差异有统计学意义(P<0.05),并且出现痉挛期的新生儿CSF中UCB高于警告期新生儿,差异有统计学意义(P<0.05),进一步研究发现血中UCB、CSF中UCB和B/A比值NBNA异常组患者均明显高于NBNA正常组新生儿,其中CSF中UCB与NBNA得分呈显著的负相关。结论:CSF中UCB检测不但能早期诊断胆红素脑病,并且能准确地反应高胆红素血症新生儿的脑功能情况。Objective： To explore the clinical application value of unconjugated bilirubin detection in cerebrospinal fluid of neo- nates with hyperbilirubinemia. Methods ： The levels of unconjugated bilirubin in eerebrospinal fluid and blood of 285 neonates with hyperbilirubinemia were detected, the ratio of uneonjugated bilirubin to albumin （B/A） was calculated, and neonatal behavioral neurological assess- ment （NBNA） was performed. Results： The levels of unconjugated bilirubin in blood and cerebrospinal fluid, B/A in blood in neonates with bilirubin eneephalopathy at warning period and spasm period were statistically significantly higher than those in neonates with simple hy- perbilirubinemia （ P 〈 0.05 ）, the level of unconjugated bilirubin in eerebrospinal fluid of neonates with bilirubin encephalopathy at spasm period was statistically significantly higher than that of neonates with bilirubin eneephalopathy at warning period （ P 〈 0. 05 ）, the levels of uneonjugated bilirubin in blood and eerebrospinal fluid, B/A in cerebrospinal fluid of neonates with abnormal NBNA score were statistically significantly higher than those of neonates with normal NBNA score, there was a significant correlation between uneonjugated bilirubin and NBNA score in eerebrospinal fluid. Conclusion ： Uneonjugated bilirubin detection in eerebrospinal fluid not only diagnose bilirubin encepha- lopathy early, but also reflect the brain function of neonates with hyperbilirubinemia.

关 键 词：脑脊液 新生儿行为神经评分 高胆红素血症 

分 类 号：R725[医药卫生—儿科]