血清总胆汁酸、转铁蛋白及C反应蛋白诊断新生儿黄疸的临床价值

Clinical value of serum total bile acid, transferrin and C-reactive protein in the diagnosis of neonatal jaundice

目的分析血清总胆汁酸、转铁蛋白及C反应蛋白对新生儿黄疸的诊断价值。方法将2016年3月至2018年6月本院收治的98例黄疸新生儿纳入观察组,并将同期于本院出生的32例正常新生儿纳入对照组。根据黄疸原因将观察组新生儿分为感染因素组(53例)、围生因素组(29例)及其他因素组(16例),另根据其黄疸严重程度将观察组新生儿分为轻度组(29例)、中度组(30例)、重度组(39例)。比较各组新生儿血清总胆汁酸、转铁蛋白及C反应蛋白水平差异,利用ROC曲线评估血清总胆汁酸、转铁蛋白及C反应蛋白对新生儿黄疸的诊断价值。结果感染因素组、围生因素组及其他因素组新生儿血清总胆汁酸、C反应蛋白水平均显著高于对照组(均P<0.05),转铁蛋白水平均显著低于对照组(均P<0.05)。感染因素组新生儿血清C反应蛋白水平均显著高于围生因素组和其他因素组(均P<0.05),围生因素组与其他因素组新生儿血清C反应蛋白水平比较差异无统计学意义(P>0.05)。血清总胆汁酸和C反应蛋白水平均为重度组>中度组>轻度组>对照组(均P<0.05),血清转铁蛋白水平则为重度组<中度组<轻度组<对照组(均P<0.05)。血清总胆汁酸、转铁蛋白及C反应蛋白对新生儿重度黄疸均具有较高的诊断效能(曲线下面积分别为0.840、0.914、0.992,均P<0.001)。结论血清总胆汁酸、转铁蛋白及C反应蛋白对新生儿黄疸严重程度的诊断效果显著,血清C反应蛋白水平还能评估黄疸病因,对于预测患儿病情发展及治疗效果有积极意义。

Objective To analyze the value of serum total bile acid, transferrin and C-reactive protein in the diagnosis of neonatal jaundice. Method 98 cases of jaundice of newborns treated in our hospital from March 2016 to June 2018 were included in observation group, and 32 normal newborns during the same period were included in control group. According to the causes of jaundice, the newborns in observation group were divided into infection factor group(n=53), perinatal factor group(n=29) and other factors group(n=16). According to the severity of jaundice, the newborns in observation group were divided into mild group(n=29), moderate group(n=30) and severe group(n=39). The levels of serum total bile acid, transferrin and C-reactive protein in each group were compared, and the diagnostic value of serum total bile acid, transferrin and C-reactive protein in neonatal jaundice was evaluated by ROC curve. Result The levels of serum total bile acid and C-reactive protein in infection factor group, perinatal factor group and other factors group were significantly higher than those in control group(all P<0.05), and the levels of transferrin were significantly lower than those in control group(all P<0.05). The level of serum C-reactive protein in infection factor group was significantly higher than that in perinatal factor group and other factor groups(all P<0.05). There was no significant difference in the serum C-reactive protein level between perinatal factor group and other factors group(P>0.05). The levels of serum total bile acid and C-reactive protein were severe group>moderate group>mild group>control group(all P<0.05), and the level of serum transferrin was severe group<moderate group<mild group<control group(all P<0.05). Serum total bile acid,transferrin and C-reactive protein were highly effective in the diagnosis of severe jaundice(the area under the curve was 0.840, 0.914 and 0.992, respectively, all P<0.001). Conclusion The serum total bile acid, transferrin and C-reactive protein have significant effects in the diagnosis of severity of neonatal jaundice. The serum C-reactive protein level can also evaluate the causes of jaundice,and it has positive significance for predicting the development of disease and treatment effects.