新生儿高胆红素血症血清前白蛋白及总胆红素/白蛋白比值与脑干听觉诱发电位的关系

Changes and significance of serum prealbumin, bilirubin/albumin ratio and BAEP in early neonatal hyperbilirubinemia

目的 研究新生儿高胆红素血症患儿血清前白蛋白水平、总胆红素/白蛋白（B/A）比值以及脑干听觉诱发电位（BAEP）的变化及其相关性,为早期预测高胆红素血症的神经毒性提供新方法.方法 根据胎龄、体质量及是否符合黄疸干预标准将出生7d内的94例新生儿高胆红素血症患儿分为BAEP正常组47例和BAEP异常组47例.检测两组患儿血清前白蛋白水平、B/A比值以及BAEP.结果 BAEP异常组血清前白蛋白水平较BAEP正常组显著降低（P〈0.01）,B/A比值升高（P〈0.05）,而总胆红素水平比较差异无统计学意义（P〉0.05）.BAEP异常组血清前白蛋白水平与B/A比值呈负相关（r=-0.637,P〈0.01）.结论 血清前白蛋白水平与B/A比值、BAEP一样均可作为早期预测胆红素神经毒性的敏感性指标.

Objective To evaluate the significance of serum prealbumin, bilirubin/albumin（ B/A ）ratio and brainstem auditory evoked potential （BAEP）for early predicting the bilirubinic neurotoxicity caused by early neonatal hyperbilirubinemia. Methods According to the gestational age, birth weight and the intervention criterion of neonatal jaundice, 94 neonates （newborn infants with a age of 1-7days） with hyperbilirubinemia were divided into two groups, one was term neonates with normal BAEP, the other was term neonates with abnormal BAEP. We detected their serum levels of total bilirubine, prealbumin, BAEP and calculated B/A ratio. Result The prealbumin levels was significantly lower and B/A ratio was higher in group of abnormal BAEP than those of control group （ P 〈 0. 01 ）, while the levels of total bilirubin were not significantly different between the two groups （ P 〉 0. 05 ）. In group of abnormal BAEP , there was a negative correlation between the level of serum prealbumin and the B/A ratio （r = -0. 637, P 〈0. 01 ）. Conclution Prealbumin may be a sensitive indicator for early predicting bilirubinic toxicity like B/A ratio and BAEP.