新生儿6-磷酸葡萄糖脱氢酶缺乏症患儿生后早期血清总胆红素水平变化  

Total serum bilirubin level changes in early postnatal glucose-6-phosphate dehydrogenase deficiency neonates

作　　者：刘芸芝 钟丹妮[2] 韦露明[2] 韦拔 蒋永江 陈继昌 

机构地区：[1]柳州市妇幼保健院新生儿科,广西545001 [2]广西医科大学第一附属医院儿科,南宁530021

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第2期201-205,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广西壮族自治区卫生计生委科研课题(Z2014377)~~

摘　　要：目的探讨新生儿6-磷酸葡萄糖脱氢酶（G-6-PD）缺乏症患儿生后早期血清总胆红素（TSB）水平变化特点。方法选择2014年1月1日~12月31日,于柳州市妇幼保健院产科出生的96例足月、广西籍新生儿为研究对象。根据脐带血G-6-PD酶活性定量测定结果,将96例新生儿分为G-6-PD缺乏组（n=31）和G-6-PD正常组（n=65）。统计学比较两组新生儿生后3h内,生后第1、2、3天TSB含量,TSB上升速率及新生儿高胆红素血症发生率差异;分析两组新生儿生后3h内TSB含量与生后第1、2、3天TSB含量及TSB上升速率间相关性。两组新生儿出生体重、胎龄、母亲年龄、自然分娩率、催产素使用率、开始排胎便时间及胎便排完时间比较,差异均无统计学意义（P〉0.05）。本研究遵循的程序符合柳州市妇幼保健院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与监护人签署临床研究知情同意书。结果 1G-6-PD缺乏组新生儿性别构成比（男性74.2%、女性25.8%）与G-6-PD正常组性别构成比（男性52.3%、女性47.7%）比较,差异有统计学意义（χ^2=4.168,P=0.041）。2G-6-PD缺乏组新生儿生后3h内及生后第1、2、3天TSB含量,TSB上升速率,以及高胆红素血症发生率[（2.7±0.6）mg/dL,（6.6±1.7）mg/dL,（10.4±2.2）mg/dL,（12.3±2.3）mg/dL,（0.14±0.04）mg/（dL·h）,45.2%]均显著高于G-6-PD正常组新生儿[（2.4±0.4）mg/dL,（5.8±1.4）mg/dL,（9.2±2.0）mg/dL,（11.0±2.6）mg/dL,（0.12±0.04）mg/（dL·h）,10.8%],且差异有统计学意义（t=3.349、2.540、2.648、2.274、2.659,P〈0.05;χ^2=14.527,P=0.000）。3G-6-PD缺乏组新生儿生后3h内TSB含量与生后第1、2、3天TSB含量及TSB上升速率间均分别存在正相关关系（r=0.393、0.619、0.596、0.549,P=0.029、0.000、0.001、0.001）;G-6-PD正常组新生儿生后3h内TSB含量与生后第1、2、3天TSB含量及TSB上升速率间均分别存�Objective To study the characteristics of total serum bilirubin （TSB） level changes in early postnatal glucose-6-phosphate dehydrogenase（G-6-PD） deficiency neonates. Methods From 1 January to 31 December 2014, a total of 96 term neonates of native place in Guangxi who were born in maternity ward of Liuzhou Maternity and Child Healthcare Hospital,were chosen as study objects. According to umbilical cord blood G-6-PD enzyme activity quantitative estimation results, the 96 neonates were divided into G-6-PD deficiency group （n = 31） and G-6-PD normal group（n = 65）. The differences between two groups in TSB content within 3 hours,at the first day,at the second day and at the third day after birth;also the TSB rising rate and the incidence rate of neonatal hyperbilirubinemia were compared. Meanwhile, the correlation between TSB contents within 3 h afar birth and TSB contents at the first, second, third days after birth, and the TSB rising rate were-analyzed. There i-t were no significant differences between two groups in birth weight, gestational age, maternal age, spontaneous labor rate, oxytocin using rate, starting and finishing time of meconium discharge （P〉 0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Liuzhou Maternity and Child Healthcare Hospital. Informed consent was obtained from the parents of each participant. Results There was significant difference between G-6-PD deficiency group （boys： 74.2%, girls： 25.8%） and G-6-PD normal group（boys： 52.3%, girls： 47.7%） in gender constituent ratio（X2 =4. 168,P=0. 041）. The TSB contents within 3 h after birth, at the first day, at the second day and at the third day after birth, the TSB rising rate and the incidence rate of neonatal hyperbilirubinemia in G-6-PD deficiency group [-（2.7 ± 0. 6） mg/dL, （6.6 ±1.3} mg/dL, （10.4±2.2） mg/dL, （12.3±2.3） mg/dL, （0.14±0.04） mg/（dL · h）, 45.2%] werehigher than those in G-6-PDnormalgroup[-（2. 4±0. 4�

关 键 词：葡糖磷酸脱氢酶缺乏 高胆红素血症 新生儿 胆红素 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]