胆红素血症新生儿血清25-(OH)D3、RBP、β2-MG水平变化及临床意义  

Levels of Serum 25-(OH)D3,RBP and β2-MG and Their Clinical Significances in Neonates with Hyperbilirubinemia

作　　者：邓刚[1] 龙礼英 张晓晴[1] 王燕[1] 雷小平 DENG Gang;LONG Liying;ZHANG Xiaoqing;WANG Yan;LEI Xiaoping(Department of Pediatrics,Zigong Maternal and Child Health- Care Hospital,Zigong 643000,China;Neonatal Department,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]自贡市妇幼保健院新生儿科,四川自贡643000 [2]西南医科大学附属医院新生儿科,四川泸州646000

出　　处：《标记免疫分析与临床》2020年第2期340-343,355,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨新生儿高胆红素血症血清相关指标的检测意义。方法回顾性分析120例高胆红素血症患儿临床资料。比较不同高胆红素血症严重程度、肾损害情况患儿血清25-羟基维生素D3[25-(OH)D3]、视黄醇结合蛋白(RBP)、β2-微球蛋白(β2-MG)水平差异,分析上述指标与血清总胆红素(TBIL)水平相关性,评估上述指标对高胆红素血症相关肾损害的诊断效能。结果血清25-(OH)D3水平在不同严重程度高胆红素血症患儿比较差异无统计学意义(P>0.05),且与患儿TBIL水平无显著相关性(P>0.05);而血清RBP、β2-MG水平比较重度>中度>轻度(P<0.05),且与患儿TBIL水平呈显著正相关性(r>0,P<0.05)。伴有与不伴有肾损害高胆红素血症患儿血清25-(OH)D3水平比较差异无统计学意义(P>0.05),而伴有肾损害高胆红素血症患儿血清RBP、β2-MG水平均明显高于不伴有肾损害患儿(P<0.05)。血清RBP、β2-MG诊断高胆红素血症相关肾损害的灵敏度分别为65.38%、84.62%,特异性分别为77.66%、80.85%,截断值分别为≥27.10 mg/L、≥7.35 mg/L。结论高胆红素血症新生儿血清RBP、β2-MG水平与病情密切相关,具有较高临床检测价值,而25-(OH)D3与病情关系不大,检测价值仍有待进一步论证。Objective To explore significance of serum related indicators in neonatal hyperbilirubinemia.Methods The clinical data of 120 children patients with hyperbilirubinemia were retrospectively analyzed.The serum 25-hydroxyvitamin D3[25-(OH)D3],retinol binding protein(RBP)andβ2-microglobulin(β2-MG)were compared among children patients with different severities of hyperbilirubinemia and renal damage,and the correlation between the above indicators and serum total bilirubin(TBIL)level was analyzed.Furthermore,the diagnostic efficacy of the above indicators on hyperbilirubinemia-related renal damage was evaluated.Results There was no significant difference in the serum 25-(OH)D3 level among children patients with different severities of hyperbilirubinemia(P>0.05),and there was no significant correlation between its level and TBIL level(P>0.05).The levels of RBP andβ2-MG showed as following:severe hyperbilirubinemia>moderate hyperbilirubinemia>mild hyperbilirubinemia(P<0.05),and they were significantly positively correlated with TBIL level(r>0,P<0.05).There was no significant difference in the serum 25-(OH)D3 level between hyperbilirubinemia children patients with or without renal damage(P>0.05),and the levels of serum RBP andβ2-MG in hyperbilirubinemia children patients with renal damage were significantly higher than those in hyperbilirubinemia children patients without renal damage(P<0.05).The sensitivities of serum RBP andβ2-MG in the diagnosis of hyperbilirubinemia-related renal damage were 65.38%and 84.62%respectively,with the specificities 77.66%and 80.85%,respectively,and the cut-off values were≥27.10mg/L and≥7.35 mg/L.Conclusion The levels of serum RBP andβ2-MG in neonates with hyperbilirubinemia are closely related to the condition and have high clinical detection value.However,25-(OH)D3 has a weak relationship with the disease condition,and the detection value remains to be further demonstrated.

关 键 词：25-羟基维生素D3 视黄醇结合蛋白 β2-微球蛋白 新生儿 高胆红素血症 

分 类 号：R722.1[医药卫生—儿科]