BNA检测134例新生儿高胆红素血症发生胆红素脑病的临床分析

RELEVANT ANALYSIS OF BILIRUBINENCEPHALOPATHY DETECTED BY NBNA IN 134 NEWBORNS WITH HYPERBILIRUBINEMIA

目的 :通过新生儿行为神经测定 (NBNA)检测新生儿高胆红素血症及胆红素脑病患儿 ,探讨NBNA检测法在胆红素脑病的应用价值。方法 :回顾性分析 134例新生儿高胆红素血症住院患儿的临床资料。结果 :134例新生儿高胆红素血症中有 4 6例发生了胆红素脑病 ,NBNA法检出 4 3例 (93.5 % ) ,常规临床观察法检出 12例 (2 6 .1% ) ,两种方法比较 ,差异有显著性意义 (χ2 =6 .75 ,P <0 .0 1) ,间接胆红素水平越高 ,胆红素脑病的发生率越高 (χ2 =12 .81,P <0 .0 1) ,伴贫血或败血症时 ,胆红素脑病发病率亦较高。结论 :NBNA检测可以较常规临床观察法更灵敏地检出新生儿高胆红素血症患儿的胆红素脑病 ,且血清间接胆红素越高 ,胆红素脑病的发生率就越高。

Objective:To find the relevant factors of bilirubinencephalopathy and assess applied value of the neonatal behavioral neurological assessment (NBNA) in newborns with hyperbilirubinemia.Method:The clinical data of 134 hyperbilirubinemia newborns was retrospective analysed . Results:Among 134 hyperbilirubinemia newborns, 46 cases had bilirubinencephalopathy, 43 cases ( 93.5 % ) of which were detected by NBNA, 12 cases (26.1%) of which were detected by routine clinical observation. There were significant difference between the two methods(χ~2=6.75,P< 0.019).The higher level of the serum indirect bilirubin,the higher incidence of bilirubinencephalopathy(χ~2=12.81, P<0.01).The incidence of bilirubinencephalopathy in newborns with anemia or sapremia was higher than those without anemia or sapremia.Conclusions: NBNA is more sensitive than routine clinical observation in detecting bilirubinencephalopathy in newborns with hyperbilirubinemia. The higher level of the serum indirect bilirubin, the higher incidence o f bilirubinencephalopathy.