新生儿高胆红素血症对其神经行为及预后的影响  

Effects of hyperbilirubinemia on nervous behavior and prognosis in neonates

作　　者：张亚京[1] 张爱平[1] 王鑫[1] 陈欣[1] 黄学英[1] 刘志晶[1] 张玲玲[1] 王惠玲[1] 斯琴[1] 

机构地区：[1]内蒙古医学院第三附属医院儿科,包头014010

出　　处：《实用儿科临床杂志》2003年第12期989-991,共3页Journal of Applied Clinical Pediatrics

基　　金：包头钢铁集团公司立项课题 [项目编号 :2 0 0 0 - 1 77]

摘　　要：目的　探讨新生儿高胆红素血症 (高胆 )对神经行为及预后的影响。方法　对 38例高胆新生儿及2 4例健康新生儿均行新生儿神经行为评分 (NBNA)和脑干听觉诱发电位 (BAEP)检测 ,幼儿期用婴幼儿智力发育量表 (CDCC)测定智力发育。结果　高胆组BAEP异常率明显高于对照组 (P <0 .0 1) ,两组Ⅰ、Ⅴ波潜伏期比较差异显著 (P <0 .0 1,P <0 .0 5 )。高胆组NBNA评分明显低于对照组 (P <0 .0 0 1) ,血清胆红素 (≥ 2 0 4 μmol/L)与NBNA评分呈显著负相关 (P <0 .0 1) ,围生因素、溶血、感染在黄疸高峰期NBNA评分明显低于对照组 (P <0 .0 1)。高胆组智力发育指数 (MDI)、心理运动发育指数 (PDI)与对照组比较差异显著 (P <0 .0 1,P <0 .0 5 ) ,智能分级比较 ,对照组明显优于高胆组 (P <0 .0 0 1)。结论　不同程度高胆均可影响新生儿神经行为能力和智能发育。新生儿高胆均应积极治疗 。Objective To explore the influence of hyperbilirubinemia on nervous behavior and prognosis in neonates.Methods Neonatol behavioral neurologilal assessment(NBNA)、brainstem auditory evoked potential(BAEP) and CDCC in 38 neonates with hyperbilirubinemia were respectively measured and 24 healthy neonates were selected as control group.Results BAEP in hyperbilirubinemia was much higher than that of control group(P< 0.01).The differences were markedly significant in incubation of I and V waves in 2 groups (P<0.01,P<0.05,respectively).NBNA in hyperbilirubinemia group was lower than that of control group(P< 0.001),mainly with active muscle tension and behavioral activities.With serum bilirubin≥204 μmol/L,bilirubin levels and NBNA were negatively correlated(P<0.01); NBNA at the peak of jaundice with peribirth,hemolysis and hyperbilirubinemia was lower than those in control group(P<0.01).The differences were marked in mental developmenl index(MDI) and psychological development index(PDI)in 2 groups(P<0.01,P<0.05).Mental ability grades in control group was significantly higher than hyperbilirubinemia group (P<0.01). Conclusions The levels of hyperbilirubinemia may influence nervous behavior and prognosis in neonates.As far as neonatal hyperbilirubinemia was concerned,active measures must be taken to reduce the sequela without regard to the causes and severity.

关 键 词：婴儿 新生 高胆红素血症 神经行为 智力发育 

分 类 号：R722.17[医药卫生—儿科]