新生儿不明原因高间接胆红素血症临床分析

Clinical analysis of full-term neonates with unknown cause of indirect hyperbilirubinemia

目的 探讨不明原因高间接胆红素血症(高胆)的临床特点及其相关因素。方法 对我院1990年～1999年收治的不明原因高胆足月新生儿316例进行回顺性分析。结果 不明原因高胆患儿占同期高胆住院患儿的20.5％(316/1 539),男∶女=1.6∶1,轻度占20.6％(65/316),中度占61.7％(195/316),重度占17.7％(56/316)。重度组母O型血所占比例和母子血型不合发生率高于轻、中度组,差异有显著性(P<0.05)。重度组胆红素值降到正常时间及光疗时间明显长于其它2组,差异有显著性(P<0.05)。结论 母亲O型血型可能为新生儿高胆发生和发展的危险因素。轻度高胆组可能包含有生理性黄疸,重度组可能包括部分新生儿ABO血型不合溶血病。

Objective To determine the clinical characteristics and related factors of unknown cause of indirect hyperbilirubinemia in full-term neonates. Methods 316 cases with indirect hyperbilirubinemia from 1990 to 1999 admitted the hospital were divided into three groups according to bilirubin peak value: light, middle or severe degree; the clinical characteristics of different groups were analyzed. Results Unknown cause of indirect hyperbilirubinemia accountsed for 20. 5 % of all neonatas with indirect hyperbilirubinemia admitted to hospital. Male cases were more frequent than famale cases. Light degree hyperbilirubinemia accountsed for 20. 6 % , middle degree 61. 7 % and sever degree 17. 7 %. Maternal blood type O was less frequent in light group than in other groups (P<0. 05). Fregnencies of ABO incompatibility and maternal blood type O were higher in severe group than in the other groups (P<0. 05). Conclusion Maternal blood type O might be a risk fartor for indirect hyperbilirubinemia in full-term neonates. Light degree group might include cases of physiological jaundice, and of severe degree group might include neonatal hemolytic disease caused by ABO incompatibility. To prevent kernicterus, positive intervention is necessary in these babies.