脑脊液胆红素的含量对患儿脑神经毒性的影响

The value of CSF bilirubin in neonatal bilirubin encephalopathy

目的探讨脑脊液(CSF)中未结合胆红素(UCB)的含量及血浆未结合胆红素/白蛋白(B/A)比值在预测患儿胆红素神经毒性中的诊断价值。方法回顾性分析2005年1月至2008年12月入院的30例胆红素脑病患儿(病例组)和30例高胆红素血症患儿行腰穿已排除新生儿败血症或颅内感染者(对照组)为研究对象,测定CSF中UCB与血中UCB、白蛋白的含量,计算B/A比值,比较胆红素脑病组CSF中UCB与血中UCB、B/A之间的相关性。结果(1)胆红素脑病组患儿CSF中UCB含量高于对照组,两组比较差异具有统计学意义(P<0.05);(2)两组患儿CSF中UCB与血中UCB均无相关性(P<0.05),与B/A比值存在相关性。结论CSF中UCB含量可以作为胆红素神经毒性的敏感指标;B/A作为胆红素毒性指标较血中UCB更有意义。

Objective To investigate value of CSF unconjugated bilirubin （UCB） and the bilirubin/albumin （B/A） ratio in neonatal bilirubin encephalopathy.Methods 30 patients with bilirubin encephalopathy From Jan.2005 to Dec.were enrolled.2008was case group and 30 cases of hyperbilirubinemia patients who have been ruled out with neonatal sepsis or intracranial infection through lumbar puncture was control group.The CSF UCB,serum UCB and albumin concentration were respectively determined and calculated B/A ratio.The correlation among the CSF UCB and serum UCB,B/A ratio were calculated in case group.Results The CSF UCB in case group was significantly higher than that in control group （P0.05）;There was no correlation （P 0.05） between the CSF UCB and serum UCB,but correlation with the B/A ratio.Conclusion The CSF UCB can be used as a sensitive indicator of bilirubin neurotoxicity while B/A radio as an indicator of bilirubin neurotoxicity is more meaningful than serum UCB.