前白蛋白和γ-谷氨酰转肽酶对新生儿高胆红素血症的影响

Effects of PA and γ-glutamyltranspeptidase on hyperbilirubinemia in neonates

目的探讨检测前白蛋白(PA)、γ-谷氨酰转肽酶(γ-GT)在判断新生儿高胆红素血症病情中的临床意义。方法选取温州医科大学附属苍南医院2017年8月至2018年8月诊治的新生儿高胆红素血症300例为研究对象,均为足月分娩,其中早期新生儿210例、晚期新生儿90例;按照高胆红素血症严重程度分为轻度(50例)、中度(150例)及重度(100例)。分别检测各组新生儿血PA、γ-GT水平。结果晚期新生儿血PA、γ-GT水平分别为(95.81±4.58)mg/L、(44.97±5.21)IU/L,明显高于早期新生儿的(94.77±6.32)mg/L、(53.88±6.32)IU/L(t=1.410、11.767,P=0.160、0.000)。随着胆红素水平的增加,患儿血PA水平逐渐下降(P<0.05);中度、重度血γ-GT水平明显高于轻度(t=2.222、2.020,P=0.027、0.046);而中度与重度血γ-GT水平相比较(t=0.712,P=0.477)。中度与重度新生儿间血PA水平相比较(t=1.741,P=0.083);而中度、重度间血PA水平明显低于轻度(t=2.357、3.277,P=0.019、0.001)。重度与中度间血清PA水平差异无统计学意义(t=0.719,P=0.474);而重度、中度血清PA水平低于轻度(t=3.234、2.117,P=0.001、0.043);三组间两两血清γ-GT水平比较,其中重度与中度间比较(t=0.297,P=0.767)、重度与轻度比较(t=0.269,P=0.788)、中度与轻度比较(t=0.013,P=0.989)差异无统计学意义。结论通过检测不同时期新生儿高胆红素血症血PA、γ-GT水平可为临床判断患儿病情提供参考,从而指导临床合理治疗。

Objective To explore the clinical significance of prealbumin(PA)andγ-glutamyltranspeptidase(γ-GT)detection in evaluation of hyperbilirubinemia in neonates at different stages.Methods From August 2017 to August 2018,300 full-term delivery patients with neonatal hyperbilirubinemia were selected,including 210 early-stage neonates and 90 late-stage neonates.According to the severity of bilirubinemia,the patients were classified into mild group(50 cases),moderate group(150 cases),and severe group(100 cases).The blood levels of PA andγ-GT of each group were detected.Results The levels of PA andγ-GT in late neonates were(95.81±4.58)mg/L,(44.97±5.21)IU/L,respectively,which were significantly higher than those in early neonates[(94.77±6.32)mg/L,(53.88±6.32)IU/L](t=1.410,11.767,P=0.160,0.000).With the increase of bilirubin level,the blood PA level was gradually decreased(P<0.05).The bloodγ-GT level of moderate and severe patients were significantly higher than that of mild ones(t=2.222,2.020,P=0.027,0.046).The blood levels ofγ-GT and PA had no statistically significant differences between moderate patients and severe patients(t=0.712,1.741;P=0.477,0.083).The blood PA level of moderate and severe patients were significantly lower than that of mild patients(t=2.357,3.277,P=0.019,0.001).The serum PA levels had no statistically significant difference between severe patients and moderate patients(t=0.719,P=0.474);and the serum PA levels of severe and moderate patients were lower than that of mild patients(t=3.234,2.117,P=0.001,0.043).The serumγ-GT levels among the three groups had no statistically significant differences(severe vs.moderate:t=0.297,P=0.767;severe vs.mild:t=0.269,P=0.788;moderate vs.mild:t=0.013,P=0.989).Conclusion By detecting the levels of PA andγ-GT in neonatal hyperbilirubinemia in different periods,it can provide a reference for clinical judgment of the condition of the children,thus guiding clinical rational treatment.