阿克苏市和宜宾市汉族新生儿高胆红素血症相关因素对比研究

Comparative study on hyperbilirubinemia and its related factors between neonates born in Aksu and Yibin

目的通过绘制四川宜宾市翠屏区汉族新生儿和新疆阿克苏市汉族新生儿生后120 h内经皮小时胆红素测定曲线图,分析不同地区相同民族之间新生儿高胆红素血症的发生率、发生时间以及峰值期,为两地区的汉族新生儿高胆红素血症的预防、评估及处理提供理论参考依据。方法选择2018年1月—2019年12月在宜宾市第三人民医院产科出生的汉族和新疆兵团第一师医院产科出生的健康新生儿为研究对象,详细记录可能与新生儿黄疸有关的相关研究指标,监测其出生后5天经皮胆红素值(TCB),分别计算每一时段的TCB P_(25)、P_(50)和P_(75)值,并绘制成曲线图,分析新生儿高胆红素血症的围生期影响因素。结果本研究共纳入新生儿1605例,在同一时龄,宜宾市汉族新生儿经皮胆红素P_(25)、P_(50)、P_(75)值均高于阿克苏市汉族新生儿;宜宾市汉族新生儿高胆红素血症发生率高于阿克苏市汉族新生儿(χ^(2)=118.5,P<0.001)。早产、开奶时间>24 h、头颅血肿、孕母应用催产素是发生新生儿高胆红素血症的独立危险因素(OR=8.331、19.640、2.982、4.019)。结论出生后5日内,新生儿胆红素水平随着日龄的增长逐渐升高,其中宜宾市汉族新生儿出生后小时胆红素水平上升速率较阿克苏汉族新生儿高,高胆红素血症的发生率亦高于阿克苏市汉族新生儿。

Objective To design the hour-specific bilirubin nomogram of Han newborns in the first 120 hours after birth,and to compare the difference in the trends of the hour-specific bilirubin and the incidence of hyperbilirubinemia between newborns in Aksu and Yibin,so as to provide evidence for the prevention,assessment and treatment of hyperbilirubinemia.Method From January 2018 to December 2019,healthy Han infants were selected in this study,who were born in the obstetrics department of the Third People′s Hospital of Yibin and the obstetrics department of the Corps First Division Hospital′s of Aksu.The related research indexes that may be related to neonatal jaundice were recorded detailedly.The transcutaneous bilirubin(TCB)value of 5 days after birth was monitored.TCB percentiles(P_(25),P_(50),P_(75))of each period were calculated and plotted.At the same time,the influence of related perinatal factors on neonatal hyperbilirubinemia was statistically analyzed.Results A total of 1605 cases were included in this study.The TCB percentiles of the Han neonates in Yibin area were higher than those in Aksu at same time points.The incidence of hyperbilirubinemia of Han neonates in Yibin was higher than that of Aksu(χ^(2)=118.5,P<0.001).Premature,first feeding time>24 h,the application of oxytocin in pregnant women and cephalohematoma were risk factors of hyperbilirnbinemia(OR=8.331,19.640,2.982,4.019).Conclusions The bilirubin level of neonates increases with the growth of age within 5 days after birth,and the rising rate of hour-specific bilirubin of Yibin neonates is higher than that of Aksu neonates.The incidence of hyperbilirubinemia of Yibin neonates is also higher than that of Aksu neonates.