微生态制剂(培菲康)治疗新生儿高胆红素血症临床疗效评价

Evaluation of clinical effect of microecological preparation (Bifico) in the treatment of neonatal hyperbilirubinemia

目的评价微生态制剂(培菲康)治疗新生儿高胆红素血症的临床疗效。方法110例在福建医科大学附属第一医院儿科住院治疗的新生儿高胆红素血症患儿分为治疗组和对照组;对照组65例给予肝酶诱导剂、光疗等综合治疗;治疗组45例在综合治疗基础上加用培菲康治疗。治疗前后检测患儿血清总胆红素和间接胆红素含量。采用SPSS11.0软件包进行统计学分析,α=0.05为显著性检验标准。结果时间-效应分析显示培菲康治疗组和对照组血清总胆红素下降值及95%CI(μmol/L)分别为142.6(126.7～158.4)、74.1(66.9～81.3),血清间接胆红素下降值及95%CI(μmol/L)为115.7(103.3～128.1)、62.6(53.7～71.7),差异有显著性(P<0.05);多元Cox回归分析显示患儿年龄、体重、孕周、入院前病程、入院血清总胆红素值/间接胆红素值及应用培菲康治疗为影响高胆红素血症患儿血清总胆红素/间接胆红素下降的主要因素;治疗组和对照组治愈例数(治愈率)分别为37例(82.2%)、8例(17.8%),好转例数(好转率)分别为47例(72.3%)、10例(27.7%),χ2=1.448,P=0.229。2组均未见明显不良反应发生。结论应用培菲康治疗新生儿高胆红素,可促进胆红素分解和排泄,减少肠肝循环,减少肠道重吸收未结合胆红素,是治疗新生儿高胆红素血症一种可靠、安全的药物。

Objective To evaluate the clinical effect of mieroecological preparation （ Bifico, oral capsules of live combined Bifidobacterium, Lactobacillus and Enterococcus） on neonatal hyperbilirubinemia. Method 110 cases of neonatal hyperbilimbinemia were divided into treatment group （45 cases） and control group （65 cases）. The control group were treated with methylprednisolone and light therapy till fully recovery, while the treatment group were treated with Bifico and basic treatment. The total bilirubin and indirect bilirubin content were tested before and after the treatment. All the data were analyzed by SPSS （version 10.0）, a = 0.05 was considered significant. Result The time-effect analysis showed that in the treatment and control groups, the decreased values of total serum bilirubin （μmol/L） and 95% CI were 142.6 （126.7 to 158.4） and 74.1 （66.9 to 81.3）, while the decline value of indirect serum bilirubin and the 95% CI （ μmol/L） were 115.7 （ 103.3 to 128.1 ） and 62.6 （53.7 to 71.7） ; the difference was statistically significant （P 〈 0.05 ）. Multivariate Cox regression analysis showed that the main factors affecting the deciline of serum bilirubin/indirect billrubin were age, weight, gestational age, pre-admission course, the level of serum bflirubin/indirect biliruhin prior to admission and application of Bifico for the treatment. The cured cases （cure rate） were 37 cases （82.2%） in the treatment groups and 8 cases （ 17.8% ） in the control group; improved patients （ improvement rate） accounted for 47 cases （72.3%） in treatment group and 10 eases （27.7%） in control group respectively （X^2 = 1. 448, P = 0. 229）. There were no significant adverse reactions in both groups. Conclusion Bifico,when used to treat neonatal hyperbilirubinemia, can promote the catabolism and excretion of bilirubin, reduce the hepatoenteral circulation and reabsorption of the bilirubin in the intestine. It is a reliable and safty drug for neonatal hyperbilirubinemia treatment.