人血白蛋白对新生儿高胆红素血症的临床疗效评价

Clinical Efficacy of Human Serum Albumin in Neonatal Patients with Hyperbilirubinemia

目的:评价人血白蛋白与蓝光照射联用治疗新生儿高胆红素血症的临床疗效。方法:选取201例新生儿高胆红素血症患儿为研究对象,根据临床治疗将其分为白蛋白组92例和非白蛋白组109例;非蛋白组患儿给予蓝光照射与丽珠肠乐胶囊治疗,白蛋白组患儿在非蛋白组基础上加用白蛋白静脉滴注治疗,其中白蛋白组患儿分为白蛋白2 g/kg单剂给药29例和1 g/kg两剂给药63例,评价白蛋白不同给药方式对新生儿高胆红素血症的疗效。结果:治疗后白蛋白组患儿的总有效率为96.74%高于非蛋白组为91.74%,经组间比较其差异无统计学意义(P>0.05),白蛋白组用药前的TBIL、IBIL、LDH测得值均明显高于非白蛋白组(P<0.05),白蛋白组和非白蛋白组的TBIL和IBIL在治疗前后的下降幅度分别为(62.3±10.0)%和(53.4±14.0)%(P<0.05),以及(60.0±10.9)%和(51.6±14.3)%(P<0.05),白蛋白组的单剂给药组患儿和两剂给药组患儿治疗前后血清学指标测得值经比较其差异无统计学意义(P>0.05)。结论:蓝光照射与白蛋白联用对重度高胆红素血症患儿可降低胆红素水平,采用白蛋白单剂与两剂给药的临床疗效相当,无需重复使用白蛋白。

Objective： To evaluate the clinical efficacy of human serum albumin（one or two doses）combined with blue light irradiation in the treatment of neonatal hyperbilirubinemia. Methods： Selected 201 cases of neonatal hyperbili- rubinemia as the object of study, and assigned to 92 cases in the albumin group and 109 cases in nonralbumin group. Li- zhuchangle capsules combined with blue light irradiation were given to the non- albumin group. On the basis of above, human serum albumin was added to the albumin group. In the albumin group, albumin was divided into two subgroups （29 case of albumin 2 g/kg in single dose and 63 cases of 1 g/kg in two doses）, comparing the clinical effect in two groups and subgroups. Results： The total effective rate in the albumin group was higher than that in the non-albumin group, but had no significant difference （96.74% vs 91.74%,P〉0.05）. The levels ofTBIL, IBIL and LDH in the albumin group were significantly higher than those in the non-albumin group. After treatment, the decreases of TBIL and IBIL in the albumin group were higher than those in the non-albumin group, having significant difference （62.3±10.0）% vs （53.4±14.0） % （P〉 0.05）, and （60.0±10.9）% vs （51.6± 14.3） % （P〉0.05）. There was no significant difference in the serum indexes between the subgroups. Conclusion： Blue light combined with albumin can further reduce the level of bilirubin in severe neonatal hyperbilirubinemia. Both subgroups showed similar efficacy, and there is no need to re-use human serum albumin.