COHB与早期新生儿高胆红素血症病因的相关性分析  

Correlation between COHB and etiologies of early neonatal hyperbilirubinemia

作　　者：陈淑芳[1] 陈妍[1] 王六燕 俞静云 方晓丹[1] CHEN Shufang;CHEN Yan;WANG Liuyan;YU Jingyun;FANG xiaodan(Department of Pediatrics, Jinhua People's Hospital, Zhejiang Jinhua 321000, China)

机构地区：[1]金华市人民医院儿科

出　　处：《中国妇幼健康研究》2019年第7期803-806,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨碳氧血红蛋白(COHB)与早期新生儿高胆红素血症不同病因的相关性。方法选择2016年1月至2018年8月金华市人民医院新生儿科收治的生后3~7天且符合入选标准的足月新生儿高胆红素血症患儿共1 426例,根据病因分为:新生儿ABO溶血病组226例,葡萄糖6磷酸脱氢酶(G6PD)缺陷病组16例,感染组128例,体内出血组59例,单纯高胆红素血症组997例。对照组为同期收治的非高胆红素血症足月儿病例120例。采用回顾性分析方法,对动脉血血气中的COHB水平进行统计分析。结果新生儿ABO溶血病组和G6PD缺陷病组的血COHB水平均明显高于其他组,与对照组比较差异均有统计学意义(t值分别为6.915、7.710,均P<0.05);同时G6PD缺陷病组的COHB水平明显高于新生儿ABO溶血病组,差异有统计学意义(t=14.614,P<0.05)。体内出血组、感染组及单纯高胆红素血症组两两之间比较,COHB水平均无显著性差异(t体内出血组-感染组=0.319,t感染组-单纯高胆红素血症组=1.419,t体内出血组-单纯高胆红素血症组=1.402,均P>0.05)。结论在新生儿ABO溶血病及G6PD缺陷病所致的新生儿高胆红素血症中COHB水平明显偏高,新生儿高胆红素血症的COHB水平偏高提示可能存在溶血性疾病,COHB水平可以作为新生儿溶血性疾病临床诊断参考。Objective To explore the correlation between carboxyhemoglobin(COHB) and different etiologies of early neonatal hyperbilirubinemia. Methods A total of 1 426 3-to 7-day-old full-term neonates with hyperbilirubinemia who were admitted to the department of neonatology of Jinhua People’s Hospital during January 2016 to August 2018 and met the inclusion criteria were selected and divided into ABO hemolytic disease group with 226 cases, glucose 6-phosphate dehydrogenase(G6 PD) deficiency group with 16 cases, 128 cases in infection group, internal hemorrhage group with 59 cases and 997 cases in simple hyperbilirubinemia group according to their etiologies. And 120 full-term neonates without hyperbilirubinemia admitted during the same period were selected as control group. Statistical analysis of COHB levels in arterial blood gases was performed by retrospective analysis method. Results The blood COHB levels in the ABO hemolytic disease group and in the G6 PD deficiency group were significantly higher than those in the other groups, and compared with the control group, the differences were statistically significant(t value was 6.915 and 7.710, respectively, both P<0.05). Meanwhile, the COHB level in G6 PD deficiency group was significantly higher than that in ABO hemolytic disease group, and the difference was statistically significant(t=14.614, P<0.05). There was no significant difference in COHB levels between the internal hemorrhage group, the infection group and the simple hyperbilirubinemia group(tinternal hemorrhage group-infection group=0.319, tinfection group-simple hyperbilirubinemia group=1.419,tinternal hemorrhage group-simple hyperbilirubinemia group=1.402, all P>0.05).Conclusion The level of COHB in neonatal hyperbilirubinemia caused by ABO hemolytic disease and G6 PD deficiency disease is obviously higher. The high level of COHB in neonatal hyperbilirubinemia may indicate presenting hemolytic disease. The level of COHB can be used as a reference for clinical diagnosis of neonatal hemolytic disease.

关 键 词：早期新生儿高胆红素血症 碳氧血红蛋白 新生儿溶血病 葡萄糖6磷酸脱氢酶缺陷病 

分 类 号：R722.1[医药卫生—儿科]