新生儿高胆红素血症血清脑源性神经营养因子的变化及意义  

Change and significance of serum brain-derived neurotrophic factor level in neonatal hyperbilirubinemia

作　　者：杜志方[1] 杨素艳[1] 刘芳[1] 吕朝霞[1] 周春风[1] 郭志梅[1] 

机构地区：[1]解放军白求恩国际和平医院儿科,石家庄050082

出　　处：《中国综合临床》2016年第7期654-656,共3页Clinical Medicine of China

摘　　要：目的：了解重度高胆红素血症新生儿血清脑源性神经营养因子（ BDNF）的临床意义。方法将我院儿科新生儿病区收治的120例足月、出生体质量＞2500 g新生儿，根据胆红素浓度分为重度高胆红素血症组和对照组。测定其血清TBIL浓度、BDNF浓度。重度高胆红素血症组出院前行颅脑MRI，比较重度高胆红素血症组和对照组BDNF的水平及BDNF与TBIL、B／A比值、颅脑MRI相关性。结果重度高胆红素血症组BDNF浓度（8．84±3．26）μg／L高于其对照组（6．24±1．71）μg／L （t＝3．88，P＜0．05），重度高胆红素血症组内 BDNF 与 B／A 呈正相关（r＝0．429，P＜0．05），但与 TBIL 无相关性（r＝0．278，P＞0．05）。颅脑MRI异常新生儿BDNF（9．53±2．77）μg／L较MRI正常者（7．81±3．76）μg／L高，但差异无统计学意义（ t＝1．439，P＞0．05）。结论重度高胆红素血症患儿分泌BDNF增加，且BDNF水平与B／A呈正相关，BDNF作为脑损伤标志物较颅脑MRI变化更敏感。Objective To explore the clinical significance of the serum brain-derived neurotrophic factor（ BDNF） level in severe neonatal hyperbilirubinemia. Methods One hundred and twenty term and birth weight〉2500 g infants admitted to the Neonatal Intensive Care Unit of Bethune nternational Peace Hospital of People Liberation Army were divided into severe hyperbilirubinemia group and control group according to their total bilirubin concentration. Total bilirubin（ TBIL） concentration,BDNF and albumin in serum were determined in two groups. In addition, craniocerebral MRI was performed in severe neonatal hyperbilirubinemia before discharge. The correlation of the BDNF, TBIL, B/A, MRI results between severe hyperbilirubinemia group and control group were compared. Results The serum BDNF levels in severe hyperbilirubinemia group was （ 8. 84 ±3. 26） μg/L,significantly higher than that in control group（（6. 24±1. 71） μg/L,t=3. 88,P〈0. 05）. In severe hyperbilirubinemia group,BDNF level was positively correlated with B/A level（r=0. 429,P〈0. 05）,but there was no correlation between BDNF and total bilirubin level（r=0. 278,P〉0. 05）. The serum BDNF level with craniocerebral MRI abnormal was （ 9. 53 ± 2. 77 ） μg/L, higher than that with craniocerebral MRI abnormal （（7. 81±3. 76） μg/L）,but there was no statistical difference between them（t=1. 439,P〉0. 05）. Conclusion In severe neonatal hyperbilirubinemia, the body can secrete BDNF increasely. BDNF level is positivelycorrelated with B/ A level. As a marker of brain damage,BDNF is sensitive than craniocerebral MRI.

关 键 词：脑源性神经营养因子 高胆红素血症 新生儿 MRI 

分 类 号：R722.17[医药卫生—儿科]