高胆红素血症新生儿血清总胆汁酸检测分析

Observation on the total bile acid in the blood serum in neonatal hyperbilirubinemia

目的探讨高胆红素血症（以下称高胆）新生儿血清胆汁酸的变化及意义。方法检测298例新生儿高胆患儿血清总胆汁酸（TBA）水平、巨细胞病毒（CMV）IgM及肝功能[天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转移酶（GGT）]，按血清总胆红素水平分为轻、重度高胆两组，并与29例对照组新生儿比较。结果轻度高胆254例，重度高胆44例，两组间AST、ALT、GGT、TBA均值和阳性率差异均无统计学意义（均P〉0．05）。轻、重度高胆组GGT和TBA均高于对照组（均P〈0．01）。214例高胆患儿检测CMV－IgM，结果全部正常。结论高胆新生儿多数存在肝脏实质损伤和胆汁淤积，血清TBA水平与黄疸程度无关，治疗时可适当使用保护肝脏的药物；TBA诊断高胆患儿肝脏实质损伤较ALT敏感。

Objective To investigate the change of the bile acid in the blood serum and its significance in the neonates with hyperbilirubinemia. Methods The levels of total bile acid（TBA）, the cytomegalovirus IGM and the liver function including the AST, the ALT and the GGT were detected in 298 neonates with hyperbilirubinemia. The neonates were divided into two groups by the levels of total bilirubin in the blood serum the light-degree and severedegree group, and which need to compare with the control group consisting of 29 neonates. Results There were 254 neonates in the light-degree group and 44 in the severe-degree group. Making comparison of the average value including AST, ALT, GGT, TBA and the positive rate, it showed that there was no statistical significance between the two groups（P 〉 0.05）. The GGT and TBA in both the light-and severe-degree group were higher than the control group, the difference had statistical significance（P 〈 0.01 ）. Testing the CMV-IgM of 214 neonates with hyperbilirubinemia, it showed that the results were all normal. Conclusion Most neonates with hyperbilirubinemia suffer from liver parenchyma injury and cholestasis,also the levels of TBA in the blood serum have no concern with the degree of jaundice. So the liver protection drugs can be properly used in the treatment. The TBA is more sensitive than the ALT to diagnose the liver parenchyma injury in neonates with hyperbilirubinemia.