525例新生儿高胆红素血症病因构成及其对肝肾功能与心肌酶谱影响的研究

Research on the etiological composition of neonatal hyperbilirubinemia and its impact on liver and kidney function and cardiac enzyme spectrum

目的研究新生儿高胆红素血症患儿的病因构成以及不同程度胆红素水平对新生儿肝肾功能及心肌酶谱的影响,来了解该院新生儿高胆红素血症的主要病因以及不同程度胆红素水平对新生儿的危害,以便进行早期预防和及时治疗。方法回顾性分析2022年1月-2023年12月本院收治的525例新生儿高胆红素血症患儿的临床资料,根据TBIL水平将其分为轻度组、中度组、重度组,同期选择60名健康新生儿作为对照组,探究不同程度新生儿高胆红素血症对新生儿心肌酶谱、肝脏、肾脏的影响。结果在525例新生儿高胆红素血症患儿中,新生儿溶血、妊娠糖尿病、胎膜早破、宫内窘迫、早产儿是引起新生儿高胆红素血症的主要病因,部分病例存在多种病因混合情况。对照组、轻度组、中度组、重度组的新生儿的TBIL水平差异有统计学意义(P<0.05);四组间肝功能(ALT、AST、GGT)差异有统计学意义(P<0.05);肾功能比较CREA差异有统计学意义(P<0.05),BUN差异无统计学意义(P>0.05);心肌酶谱比较中CK、CK-MB、LDH差异有统计学意义(P<0.05);AST、GGT、ALT、CREA、CK、CK-MB、LDH与TBIL水平呈显著正相关(P<0.05),而BUN与TBIL水平无相关。结论新生儿高胆红素血症患儿中,新生儿溶血、妊娠糖尿病、胎膜早破、宫内窘迫、早产儿等围生期因素是病因的主要构成,且随着TBIL水平升高,对肝脏、肾脏、心脏等功能的损害程度也会增加,因此需要预防可能导致新生儿高胆红素血症的相关病因,并且密切关注患儿的肝脏、肾脏、心脏功能,及时监测病情进展,并采取相应治疗措施。

Objective To investigate the etiological composition in neonates with hyperbilirubinemia and to assess the effects of varying bilirubin levels on liver,kidney function,and cardiac enzyme profiles in order to understand the predominant causes of neonatal hyperbilirubinemia at our institution and the potential harm that different bilirubin levels pose to neonates,facilitating early prevention and prompt treatment.Methods A retrospective analysis was conducted on the clinical data of 525 neonates with hyperbilirubinemia admitted to our hospital from January 2022 to December 2023.Patients were categorized into mild,moderate,and severe groups based on total bilirubin(TBIL)levels.Additionally,60 healthy neonates served as a control group to explore the impact of varying degrees of neonatal hyperbilirubinemia on cardiac enzyme profiles,liver,and kidney function.Results The primary causes of neonatal hyperbilirubinemia among the 525 cases were neonatal hemolysis,gestational diabetes,premature rupture of membranes,intrauterine distress,and premature birth,with some cases exhibiting multiple etiological factors.Statistically significant differences were observed in TBIL levels among the control,mild,moderate,and severe groups.There were also significant differences in liver function measures(ALT,AST,GGT)across the groups(P<0.05).Renal function differences were noted in creatinine(CREA)but not in blood urea nitrogen(BUN)(P<0.05).Cardiac enzyme profile differences were observed for creatine kinase(CK),CK-MB,and lactate dehydrogenase(LDH)(P<0.05).AST,GGT,ALT,CREA,CK,CK-MB,and LDH were significantly positively correlated with TBIL levels(P<0.05),whereas no correlation was found between BUN and TBIL levels.Conclusions Neonatal hemolysis,gestational diabetes,premature rupture of membranes,intrauterine distress,and premature birth are the main contributors to the etiology of neonatal hyperbilirubinemia.As TBIL levels rise,so does the degree of impairment of liver,kidney,and heart functions.Therefore,it is crucial to prevent the etiological factors leading to neonatal hyperbilirubinemia,closely monitor the liver,kidney,and heart functions in affected neonates,timely detect disease progression,and implement appropriate treatment measures.