导致新生儿病理性黄疸危险因素的临床研究

Clinical Study Leading to Risk Factors for Neonatal Pathological Jaundice

目的探讨导致新生儿病理性黄疸的危险因素,为新生儿病理性黄疸防控提供依据。方法以2017年1月至2018年12月到本院就诊的病理性黄疸新生儿187例病历资料为研究对象(研究组),采用SPSS19.0分析软件经单因素归纳分析后行多因素Logistic回归计算,分别就导致新生儿黄疸的红细胞6-磷酸葡萄糖脱氢酶缺乏症、新生儿ABO溶血病、感染性黄疸、母乳性黄疸、早产新生儿等因素进行回顾归纳分析,探讨导致新生儿病理性黄疸的危险因素;同时选取同期于本院分娩的生理性黄疸新生儿100例为对照组,并将前述对应指标进行对比分析。结果病理性新生儿黄疸临床因素研究结果中,研究组红细胞6-磷酸葡萄糖脱氢酶缺乏症(G-6-PD缺乏症)、新生儿ABO溶血病、感染性黄疸、母乳性黄疸、早产新生儿、白蛋白<25 g/L导致新生儿病理性黄疸的发生率与对照组有统计学差异(均P<0.05);SPSS19.0软件分析结果显示:感染性黄疸(OR=4.745,95%CI:1.975~9.016)、早产儿(OR=3.751,95%CI:1.706~8.437)、红细胞6-磷酸葡萄糖脱氢酶缺乏症(OR=3.751,95%CI:1.806~10.026)、新生儿ABO溶血(OR=2.473,95%CI:1.761~7.727)、母乳性黄疸(OR=2.158,95%CI:1.703~6.017)、白蛋白<25 g/L(OR=3.705,95%CI:1.617~7.043)是新生儿病理性黄疸的独立危险因素;Pearson分析结果显示:新生儿病理性黄疸发生率与新生儿感染发生率[(OR=1.357,95%CI:1.095~4.715);r=0.751,P<0.05]、G-6PD缺乏症[(OR=1.469,95%CI:1.381~6.718);r=0.741,P<0.05]、低白蛋白血症[(OR=1.472,95%CI:1.268~5.179);r=0.603,P<0.05]显著相关。结论新生儿病理性黄疸与新生儿本身基础疾病、低蛋白血症等因素有关。

Objective To explore the risk factors for neonatal pathological jaundice,and to provide evidence for neonatal pathological jaundice prevention and control.Methods The data of 187 cases of pathological jaundice from January 2017 to December 2018 were studied in the study group(study group).Multivariate logistic regression was performed by SPSS19.0 analysis software after single factor induction analysis.In retrospective analysis of factors such as erythrocyte 6-phosphate glucose dehydrogenase deficiency,neonatal ABO hemolytic disease,infectious jaundice,breast milk jaundice,and premature neonates,the neonatal jaundice causes pathological jaundice in neonates.The risk factors were also selected.100 cases of physiological jaundice newborns delivered in our hospital at the same time were selected as the control group,and the corresponding indicators were compared and analyzed.Results Among the findings of clinical factors for pathological neonatal jaundice,the study group was erythrocyte glucose 6-phosphate dehydrogenase deficiency(G-6-PD deficiency),neonatal ABO hemolytic disease,infectious jaundice,breast milk jaundice,and premature neonates.The incidence of neonatal pathological jaundice caused by albumin<25 g/L was statistically different from that of the control group(both P<0.05);SPSS19.0 software analysis showed that infectious jaundice(OR=4.745,95%CI:1.975-9.016),premature infants(OR=3.751,95%CI:1.706-8.437),red blood cell 6-phosphate glucose dehydrogenase deficiency(OR=3.751,95%CI:1.806-10.026),neonatal ABO hemolysis(OR=2.473,95%CI:1.761-7.727),breast milk jaundice(OR=2.158,95%CI:1.703-6.017),albumin<25 g/L(OR=3.705,95%CI:1.617-7.043)Yes Independent risk factors for neonatal pathological jaundice;Pearson analysis showed that the incidence of neonatal pathological jaundice and neonatal infections[(OR=1.357,95%CI:1.095-4.715);r=0.751,P<0.05],G-6 PD deficiency[(OR=1.469,95%CI:1.381-6.718);r=0.741,P<0.05],low albumin Disease[(OR=1.472,95%CI:1.268-5.179);r=0.603,P<0.05]significant correlation.Conclusion Neonatal pathological jaundice is related to the underlying diseases of the newborn,hypoproteinemia and other factors.