窒息对新生儿高胆红素血症的影响

Effect of asphyxia on newborn hyperbilirubinaemia

目的 探讨窒息对新生儿高胆红素血症的影响。方法 154名足月窒息新生儿和87名正常新生儿生后第1、2、3天监测血清胆红素及对有皮肤黄染的新生儿追踪监测。结果 轻度窒息新生儿生后第1、2、3天平均血清胆红素浓度为(49.7±11.l)μmol/L、(84.6±13.8)μmol/L和(152.6±15.3)μmol/L,重度窒息儿为(64.3±12.2)μmol/L、(10.3±13.3)μmol/L和(13.2±14.2)μmol/L,正常新生儿为(80.1±13.6)μmol/L、(126.3±16.2)μmol/L和(17.9±11.4)μmol/L,重度窒息组新生儿生后第1、2天血清胆红素水平高于轻度窒息组,而第3天低于轻度窒息组,2组血清胆红素均低于正常新生儿组,差异均有显著性(P<O.05,P<O.01)。154名窒息患儿中高胆红素血症发生率为13.7％(21/154),其中轻度窒息组高胆红素血症发生率为13.7％(14/102),重度窒息组为13.5％(7/52)。轻度窒息组高胆红素发病时间(3.4±0.8)d早于重度窒息组(4.3±0.8)d;黄疸消退时间(11.1±0.9)d晚于重度窒息组(9.9±0.5)d;血清胆红素的高峰值(328.3±18.3)μmol/L较重度窒息组(306.1±15.4)μmol/L高;出现高峰时间(4.7±0.7)d,早于重度窒息组(5.7±0.9)d,差异有显著性(P<0.05,P<0.01)。结论 足月窒息新生儿中高胆红素血症发病率较低,高胆的严重程度与窒息程度不一致。

Objective To explore the effect of asphyxia in neonatal hyperbilirubinaemia.Methods Serum bilirubin was measured in 154 full-term neonates with asphyxia and in 87 normal neonates of 1 or 2 or 3 days of age, after the discovery of jaundice. Results The levels of bilirubin on 1, 2. 3days of age in neonates with mild asphyxia were (49. 7± 11.1)μmol/L, (84. 6 ±13.8) μmol/L, (152. 6±15. 3)μmol/L and severe asphyxia (64.3±12.2) μmol/L, (108. 3±13.3) μmol/L and (130. 2±14.2) μmol/L, which were signifacant lower than that in normal neonates. The levels of bilirubin on 1, 2 days of age in neonates with severe asphyxia were signifacant higher than that in neonates with mild asphyxia. The level of bilirubin on 3 day of age was signifacant lower than that in neonates with mild asphyxia. The rate of hyperbilirubinaemia in 154 cases was 13.7 % (21/154). Mild asphyxia was 13- 7 % (14/102) and severe asphyxia was 13.5 % (7/52). The duration of the occurrence of hyperbilirubinaemia in neonates with mild asphyxia was shorter than that of neonates with severe asphyxia . The duration of jaundice was longer than that of neonates with severe asphyxia. The duration of the occurrence of peak value was shorter than that of neonates with severe asphxia and the peak value of bilirubin (328. 3±18. 3 μmol/L) was higher than that of neonates with severe asphyxia (306. 1±15.4)μmol/L. Conclusion The rate of hyperbilirubinaemia in full-term neonates with asphyxia is low. The degree of hyperbilirubin-aemia is not in line with the degree of asphyxia. Pay attention to the dual nature of bilirubin when hyperbihrubinaemia in full-term neonates with asphyxia is beening predicated.