新生儿极重度高胆红素血症的危险因素分析

Analysis of risk factors for extremely severe neonatal hyperbilirubinemia

目的探讨新生儿极重度高胆红素血症的危险因素。方法回顾性分析浙江省杭州市第一人民医院2015年1月-2019年12月收治的高胆红素血症患儿105例,按患儿病情严重程度分为极重度高胆红素血症患儿(EHB组)21例,重度高胆红素血症患儿(SHB组)84例,分析极重度高胆红素血症患儿的相关危险因素。结果EHB组合并感染例数、B/A和BE值均高于SHB组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,合并感染和高B/A水平是极重度高胆红素血症的危险因素,OR值分别为3.700(95%CI:1.205~11.364)和79.593(95%CI:8.613~735.516)。结论合并感染是极重度高胆红素血症的独立危险因素,临床需要积极处理高胆红素血症患儿的感染情况,以免发展为极重度高胆红素血症,危及生命。本文发现B/A值是新生儿极重度高胆红素血症的相关危险因素,但两组血清白蛋白水平相近,极重度高胆红素血症B/A值升高主要为TSB升高导致,暂不考虑B/A值是新生儿极重度高胆红血症的相关危险因素。

Objective To investigate the risk factors of neonatal extremely severe hyperbilirubinemia.Methods A retrospective analysis of 105 inpatients with hyperbilirubinemia admitted to the First People’s Hospital of Hangzhou City,Zhejiang Province from January 2015 to December 2019 was performed.There were 21 children with extremely severe hyperbilirubinemia(EHB group)and 84 children with severe hyperbilirubinemia(SHB group),and the related risk factors of children with extremely severe hyperbilirubinemia were analyzed.Results The number of co-infection rate,B/A and BE values in the EHB group were higher than those in the SHB group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that co-infection and high B/A level were risk factors for extremely severe hyperbilirubinemia,with OR values of 3.700(95%CI:1.205~11.364)and 79.593(95%CI:8.613~735.516).Conclusion Complicated infection is an independent risk factor for severe hyperbilirubinemia,and it is necessary to actively treat the infection in children with hyperbilirubinemia,so as to avoid the deterioration of severe hyperbilirubinemia,which is life-threatening.We found that B/A is a statistically related risk factor for neonatal extremely severe hyperbilirubinemia,but the serum albumin levels of the two groups were similar,and the increase of B/A in extremely severe hyperbilirubinemia was mainly caused by the increase of TSB,so B/A is not considered as a clinically relevant risk factor for neonatal extremely severe hyperbilirubinemia.