新生儿黄疸胆红素、胆汁酸及白蛋白水平与NBNA评分的相关性

Correlation of bilirubin,bile acids,albumin levels with NBNA score in neonatel jaundice

目的 探究新生儿黄疸(NJ)胆红素、胆汁酸(TBA)、白蛋白(ALB)水平变化及与新生儿神经行为测定(NBNA)评分的相关性。方法 选取2020年2月至2021年12月河南省济源市人民医院120例NJ患儿作为研究组,120名健康新生儿作为对照组。检测两组血清间接胆红素(IBIL)、总胆红素(TBIL)、TBA、ALB水平,采用受试者工作(ROC)曲线评价血清IBIL、TBIL、TBA、ALB对NJ类型鉴别的价值,采用Pearson分析NJ患儿血清IBIL、TBIL、TBA、ALB与NBNA评分的相关性。结果 血清IBIL、TBIL、TBA、ALB水平:病理性黄疸患儿>生理性黄疸患儿>对照组,差异均有统计学意义(P<0.05);血清IBIL、TBIL、TBA、ALB联合鉴别NJ类型的曲线下面积(AUC)为0.912,联合鉴别的最佳敏感度、特异度分别为86.84%、88.64%;生理性黄疸患儿NBNA评分高于病理性黄疸患儿,急性胆红素脑病发生率(18.18%)低于病理性黄疸患儿(38.16%),差异均有统计学意义(P<0.05);NJ患儿血清IBIL、TBIL、TBA、ALB与NBNA评分呈负相关(P<0.05)。结论 NJ患儿血清IBIL、TBIL、TBA、ALB水平均与NJ患儿NBNA评分间存在负相关关系,有助于临床评估急性胆红素脑病的发生风险。

Objective To investigate the changes of bilirubin,total bile acid(TBA)and albumin(ALB)levels in neonatal jaundice(NJ)and their correlation with neonatal behavioral neurological assessment(NBNA)score. Methods 120 cases of children with NJ in Jiyuan People’s Hospital,Henan Province,from February 2020 to December 2021 were selected as the study group and 120 healthy newborns as the control group. Serum indirect bilirubin(IBIL),total bilirubin(TBIL),TBA,and ALB levels were measured in both groups,and the value of serum IBIL,TBIL,TBA,and ALB for the identification of NJ types was evaluated using subject work(ROC)curves,and the correlation between serum IBIL,TBIL,TBA,and ALB and NBNA scores in children with NJ was analyzed by Pearson. Results Serum IBIL,TBIL,TBA,ALB levels:children with pathological jaundice > children with physiological jaundice > control group,the differences were statistically significant(P<0.05). The area under the curve(AUC)of serum IBIL,TBIL,TBA,ALB combined to identify the type of NJ was 0.912,and the best sensitivity and specificity of combined identification were86.84%,88.64%,respectively. The NBNA score of children with physiological jaundice was higher than that of children with pathological jaundice,and the incidence of acute bilirubin encephalopathy(18.18%)was lower than that of children with pathological jaundice(38.16%). 88.64%;the NBNA scores of children with physiological jaundice were higher than those of children with pathological jaundice,and the incidence of acute bilirubin encephalopathy(18.18%)was lower than that of children with pathological jaundice(38.16%),and the differences were statistically significant(P<0.05). The serum IBIL,TBIL,TBA and ALB of NJ children were negatively correlated with the NBNA score(P<0.05). Conclusion The serum levels of IBIL,TBIL,TBA and ALB in children with NJ were negatively correlated with the NBNA score in children with NJ,which was helpful for clinical assessment of the risk of acute bilirubin encephalopathy.