早产儿呼吸暂停与高胆红素血症的关系

Relationship between apnea and hyperbilirubinemia in premature infants

目的探讨高胆红素血症对早产儿呼吸暂停的影响。方法对体质量>1500g伴呼吸暂停的早产儿进行治疗前后心率、血清胆红素水平、血气分析,并与足月产儿对照;对出生第1天和第3天、体质量<1500g有或无呼吸暂停的早产儿进行血清胆红素水平、血气分析比较。结果体质量>1500g伴呼吸暂停的早产儿和足月儿中,不同程度血间接胆红素增高者分别占92.5%和70.0%。在体质量<1500g极低体重早产儿中,出生第1天有呼吸暂停者,血间接胆红素水平明显比无明显呼吸暂停的高。常规治疗后第3天,随胆红素水平相对降低,呼吸暂停明显改善。结论血清胆红素水平增高是早产儿呼吸暂停的原因之一,降胆防治有利于改善早产儿呼吸暂停。

Objective To explore the association between hyperbilirubinemia and apnea in premature infants.Methods Premature infants with apnea and birth weight 〉1500 g were tested for the heart rate,serum level of bilirubin,saturation of blood oxygen（SO2） and partial pressure of oxygen（PO2） before and aftertreatment,with term infants serving as the control.A comparative analyses of the serum level of bilirubin,SO2 and PO2 were carried out in the premature infants with birth weight 〈1500 g suffering apneic syndrome or not on the first and third days after birth.Results Of the premature and term infants with apnea and birth weight 〉1500 g,92.5% and 70.00% showed increased serum level of indirect bilirubin（IBIL）,respectively.The infants with birth weight 〈1500 g who presented the syndrome of apnea on the first day after birth had significantly higher levels of IBIL than those without an apparent syndrome of apnea.A three-day conventional therapy resulted in an obvious improvement of apneic syndrome and lowered bilirubin level.Conclusion Increased bilirubin level can be one of the reasons for the development of apnea in premature infants,and therapies for reducing bilirubin level can ameliorate the syndrome of apnea.