VLBW早产儿出生后的TBIL水平变化及快速上升的危险因素分析  

Changes of TBIL levels and risk factor analysis of rapid rising for preterm infants with very low born weight

作　　者：王娟[1] 粱宽 WANG Juan;LIANG Kuan(Department of Nosocomial Infection Control,People′s Hospital of Baoji City,Baoji,Shaanxi 721000,China;Department of Pediatrics,People′s Hospital of Baoji City,Baoji,Shaanxi 721000,China)

机构地区：[1]陕西省宝鸡市人民医院医院感染控制科,陕西宝鸡721000 [2]陕西省宝鸡市人民医院医院儿科,陕西宝鸡721000

出　　处：《检验医学与临床》2023年第3期365-369,共5页Laboratory Medicine and Clinic

基　　金：宝鸡市人民医院科研课题(2020-099)。

摘　　要：目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血清TBIL水平上升率”,研究对象被分为A组(血清TBIL水平上升率≤90%)275例和B组(血清TBIL水平上升率>90%)42例。比较两组早产儿的临床特征和血清TBIL水平的变化。采用Pearson相关分析光疗相关参数与血清TBIL上升率的关系。使用Logistic回归模型分析血清TBIL快速上升的相关因素。结果VLBW早产儿出生后血清TBIL水平随着出生时间的延长而增加(P<0.05),血清TBIL水平上升率与光疗开始时的年龄呈负相关,与光疗持续时间呈正相关(r=-0.766、0.478,P<0.05)。与A组相比,B组婴儿的胎龄明显减少,出生体质量明显降低,5 min Apgar评分明显减少,开始光疗的年龄较小,光疗总持续时间较长,差异有统计学意义(P<0.05)。胎龄、出生体质量和5 min Apgar评分为VLBW早产儿血清TBIL水平快速上升的相关因素。结论血清TBIL水平上升率可作为VLBW早产儿早期光疗的指标,血清TBIL水平的快速上升与较低胎龄、较低出生体质量和5 min Apgar评分有关。Objective To analyze the levels of serum total bilirubin(TBIL)for preterm infants with very low born weight(VLBW),the changes of serum TBIL and the risk factors of rapid rising of serum TIBL.Methods A total of 317 preterm infants with VLBW,who were born and treated in the Neonatal Intensive Care Unit in the hospital from January 2019 to December 2021,were selected as the research objects and divided into the group A with increase rate of serum TBIL≤90%(275 cases)and the group B with increase rate of serum TBIL>90%(42 cases)according to the increase rate of serum TBIL.The clinical characteristics and changes of serum TBIL in the two groups were compared.The Pearson correlation was used to analyze the relationship between phototherapy-related parameters and the increase rate of serum TIBL.Logistic regression model was used to analyze the factors related to the higher increase rate of serum TIBL.Results The levels of serum TBIL increased with the increase of birth time(P<0.05),the increase rate of serum TBIL was negatively correlated with the age of starting phototherapy and positively correlated with the duration of phototherapy(r=-0.766,0.478,P<0.05).Compared with the group A,the gestational age of group B decreased obviously,the birth weight reduced significantly,the 5-minute Apgar score decreased,the age of starting phototherapy was younger and the total duration of phototherapy was longer,with statistically significant difference(P<0.05).Gestational age,birth weight and 5-minute Apgar score were related with the rapid rising of serum TBIL for preterm infants with VLBW.Conclusion The increase rate of serum TBIL can be used as an indicator of early phototherapy for preterm infants with VLBW,and the rapid rising of serum TBIL is associated with lower gestational age,lower birth weight and lower 5-minute Apgar score.

关 键 词：早产儿 极低体质量出生儿 胆红素 光疗 危险因素 

分 类 号：R722.6[医药卫生—儿科]