新生儿黄疸患儿血清TBA、TRF水平与病情严重程度的关系及临床意义  

Corelations between Serum Levels of TBA and TRF with Severity of Disease in Children with Neonatal Jaundice and Its Clinical Significance

作　　者：赵辉[1] 杨薇 刘国春 段德民[4] ZHAO Hui;YANG Wei;LIU Guo-chun;DUAN De-min(Department of Clinical Laboratory,Aviation General Hospital,Beijing 100012,China;Department of Neonatal Medicine,Aviation General Hospital,Beijing 100012,China;Department of Clinical Laboratory,Tongzhou District of Dongzhimen Hospital of University of Traditional Chinese Medicine,Beijing 101100,China;Institute of Biophysics,Chinese Academy of Sciences,Beijing 100101,China)

机构地区：[1]航空总医院检验科,北京100012 [2]航空总医院新生儿内科,北京100012 [3]中医药大学东直门医院通州院区检验科,北京101100 [4]中科院生物物理研究所,北京100101

出　　处：《临床误诊误治》2022年第5期98-101,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金项目(8207080182)。

摘　　要：目的探究新生儿黄疸(NJ)患儿血清总胆汁酸(TBA)、转铁蛋白(TRF)水平与病情严重程度的关系及临床意义。方法选取2017年1月—2021年8月我院NJ患儿120例作为研究组,另选取同期50例健康新生儿作为对照组。比较2组血清TBA、TRF、总胆红素(TBIL)水平;不同黄疸类型、不同病情程度患儿血清TBA、TRF水平;分析血清TBA、TRF水平与病情程度的关系;比较疗效良好、不良患儿治疗前及治疗后3、5 d血清TBA、TRF水平;分析治疗前血清TBA、TRF水平预测NJ患儿疗效的价值。结果研究组血清TBA、TBIL水平均较对照组高,血清TRF水平较对照组低(P<0.01)。病理性黄疸患儿血清TBA水平较生理性黄疸患儿高,血清TRF水平较生理性黄疸患儿低(P<0.05)。重度患儿血清TBA水平较中度、轻度患儿高,中度患儿较轻度患儿高,重度患儿血清TRF水平较中度、轻度患儿低,中度患儿较轻度患儿低(P<0.05)。Spearman相关性分析显示,血清TBA水平与NJ患儿病情程度呈正相关(r=0.707,P<0.05),血清TRF水平与NJ患儿病情程度呈负相关(r=-0.745,P<0.05)。疗效不良患儿治疗前及治疗后3、5 d血清TBA水平均较疗效良好患儿高,血清TRF水平均较疗效良好患儿低(P<0.01);且疗效良好患儿治疗后3、5 d血清TBA水平均较治疗前降低,血清TRF水平较治疗前升高(P<0.05)。血清TBA、TRF单独预测疗效的曲线下面积(AUC)为0.764、0.713,二者联合预测的AUC最大,为0.913。结论NJ患儿血清TBA、TRF水平与病情严重程度密切相关,早期检测二者水平有助于判断病情严重程度,且在预测疗效方面也具有一定价值。Objective To explore correlations between serum levels of total bile acid(TBA)and transferrin(TRF)with severity of disease in children with neonatal jaundice(NJ)and its clinical significance.Methods A total of 120 children with NJ between January 2017 and August 2021 were selected as research group,and other 50 healthy newborns at the same period were selected as control group.Serum levels of TBA,TRF and total bilirubin(TBIL)were compared between two groups.Serum levels of TBA and TRF in children with different types of jaundice and different degrees of illness were also compared.Correlations between serum levels of TBA and TRF with the severity of the disease were analyzed.Serum levels of TBA and TRF were compared before and after treatment for 3 and 5 d in children with good and poor therapeutic effects.Values of serum levels of TBA and TRF before treatment in prediction of the therapeutic effect of NJ children were analyzed.Results Compared with those in control group,serum levels of TBF and TRF were significantly lower,while serum TRF level was significantly lower in research group(P<0.01).Compared with those in children with physiological jaundice,serum TBA level was significantly higher,while serum TRF level was significantly lower in children with pathological jaundice(P<0.05).Serum TBA level in severe NJ children was the highest,followed by those in moderate and mild NJ children;serum TRF level in severe NJ children was the lowest,followed by those in moderate and mild NJ children(P<0.05).Spearman correlation analysis showed that serum TBA level was positively correlated with the severity of NJ children(r=0.707,P<0.05),and serum TRF level was negatively correlated with the severity of NJ children(r=-0.745,P<0.05).Before and after treatment for 3 and 5 d in children with poor therapeutic effects,serum TBA levels were significantly higher,while serum TRF levels were significantly lower than those in children with good therapeutic effects(P<0.01).After treatment for 3 and 5 d,serum TBA levels were significan

关 键 词：黄疸 新生儿 胆汁酸 转铁蛋白 胆红素 病情程度 相关性 预测价值 

分 类 号：R722.17[医药卫生—儿科]