血清游离胆红素的相关因素的研究

Study of correlated factors of serum free bilirubin in neonatal jaundice

目的测定新生儿黄疸高峰期游离胆红素（Bf）的浓度,分析Bf的相关因素。方法以2007年7~10月入院的黄疸新生儿为研究对象,在其黄疸高峰期检测Bf、血清总胆红素（TSB）、胆红素/白蛋白（B/A）,并监测其伴随疾病、用药和治疗情况,对Bf和上述指标进行相关分析与多因素分析。结果入选172例,TSB（236.1±66.5）μmol/L（88.9~427.5μmol/L）,Bf（13.2±11.0）nmol/L（2.0~53.9 nmol/L）。相关分析显示,TSB与Bf呈正相关（r=0.546,P〈0.01）,B/A和Bf呈正相关（r=0.514,P〈0.001）。以Bf为因变量,多元线性回归分析得到回归方程Y=-12.634＋0.130X1-0.810X2＋5.139X3,标准化偏回归系数X1为0.774,X2为-0.258,X3为0.110。结论Bf与TSB、黄疸高峰日龄及感染相关,Bf与TSB高度相关,评估胆红素神经毒性除TSB外,还需综合考虑其他危险因素。

Objective To measure the level of free bilirubin（Bf） during the peak of neonatal jaundice of newborns and analyze the correlated factors of Bf.Methods The newborns admitted in neonatal ward of author′s hospital during July 2007 to October 2007 for neonatal jaundice were selected in this study,their levels of Bf,total serum bilirubin（TSB）,bilirubin/albumin ratio（B/A）were measured and their associated diseases and medications used were monitored during the peaks of neonatal jaundice.The correlation analysis and multi-factor analysis between Bf and such factors were performed.Results There were 172 cases admitted in this study;the levels of TSB and Bf were（236.1±66.5） μmol/L（88.9-427.5 μmol/L） and（13.2±11.0） nmol/L（2.0-53.9 nmol/L）respectively.The correlation analysis showed positive correlation between TSB and Bf（r=0.546,P〈0.01）,and between B/A and Bf（r=0.514,P〈0.01）.It also showed that if took Bf as the dependent variable,multiple linear regression analysis concluded the linear regression equation as Y=-12.634＋0.130X1-0.810X2 ＋5.139X3.Conclusion The level of Bf is correlated with level of TSB,age of peak of jaundice and neonatal infection.Although the level of TSB has the strongest correlation with Bf,one should consider all of the above factors when assess the neurotoxicity of bilirubin of newborn.