总胆红素与白蛋白比值对预测胆红素神经毒性价值的探讨  

Significance of B/A ratio in predicting bilirubin encephalopath

作　　者：岳荣丽[1] 齐素萍[1] 辛明 张建勇[1] 舒志荣[2] 

机构地区：[1]济南军区88医院,山东泰安271000 [2]青岛大学医学院附属医院

出　　处：《中国实用儿科杂志》2003年第1期18-20,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨总胆红素 /白蛋白比值 (B/A)与脑干听觉诱发电位 (ABR)的关系及在预测胆红素神经毒性中的价值。方法　将 43例足月非溶血性高胆红素血症患儿 ,根据ABR表现分成A、B、C三组 ,比较三组患儿血清总胆红素 (TBC)、B/A的变化 ,分析B/A与ABR的相关性。结果　与A、B两组比较 ,C组TBC及B/A比值均明显升高 (P <0 0 5 ,P <0 0 1) ,B/A比值与ABR异常密切相关 (χ2 =7 76 ,P <0 0 5 )。结论　B/A比值是预测胆红素脑病的良好指标 ,对于足月高胆患儿B/A比值 >5 0× 10 -3 者应采取积极的治疗措施。Objective In order to evaluate the value of the bilirubin/albumin(B/A)ratio in the management of hyperbilirubinemia,we compared it with abnormal auditory brainstem responses(ABRs).Methods\ ABRs and B/A ratio in 43 term newborns with hyperbilirubinemia were measured before treatment.They were divided into three groups according to the results of ABR:group A(n=25) with normal ABR,group B(n=8) with poor amplitude of wave Ⅰ or wave Ⅲ or wave Ⅴ,and group C(n=10) with two or more abnormal indexes.Results\ Compared with group A and B,the TBC and B/A ratio were significantly higher(P<0.05,P<0.01).Abnormal ABR findings were closely associated with the B/A ratio(P<0 05).Conclusion\ These results suggest that the B/A ratio is a good to evaluate the possible risk of bilirubin encephalopathy in full-term newborns.Treatment will be carried out for the neonate with non-hemolytic hyperbilirubinemia when their B/A ratio >5 0×10 -3 .

关 键 词：新生儿 高胆红素血症 总胆红素 白蛋白 脑干听觉诱发电位 胆红素神经毒性 

分 类 号：R722.17[医药卫生—儿科]