高胆红素血症对新生儿神经行为及其预后的影响

EFFECT OF HYPERBILIRUBINEMIA ON NEONATAL NEUROLOGICAL BEHAVIOUR AND PROGNOSIS

探讨高胆红素血症对新生儿神经行为及其预后的影响,通过对38例高胆患儿在新生儿期进行神经行为评分(NBNA)检测、婴幼儿期用婴幼儿智力发育量表(CDCC)测定智力发育。结果显示:高胆组NBNA评分明显低于对照组(P<0.001),主要失分项目为行为能力和主动肌张力。在血清胆红素≥204μmol/L时,胆红素水平与NBNA评分呈显著负相关(P<0.01);围产因素、溶血、感染组在黄疸高峰期NB-NA评分低于对照组(P<0.01)。高胆组MDI、PDI与对照组比较差异显著(P<0.001),智能分级比较,对照组优于高胆组(P<0.01,P<0.05)。结果提示,不同程度高胆红素血症无论是不同龄别生理性特点或为不同而更较复杂的病理特异,均可能影响新生儿神经行为能力和智能发育。对新生儿高胆红素血症,无论其程度和病因如何均应积极治疗,尽量减少后遗症的发生。

To investigate the influence of hyperbilirubinemia on neurological behavior and prognosis of neo-nates, NBNA and CDCC were measured respectively in 38 neonates and young children with hyperbiliru-binemia to evaluate intelligence development. NBNA in hypeii>ilirubinemia group was obviously lower than that of control group ( P < 0.001) . Main causes of low NBNA were poor behavior ability and active muscle tone. There was megative correlation between serum bilirubin and NBNA (P <0.01) when serum bilirubin ≥204 μmol/L. NBNA was lower in high risk, hemolysis and infection perinatal higt risk, infant during the preiod of peak bilirubin. ( P < 0.01) MDI and PDI in hyperbilirubinemia group had signifi-cant difference to control group. The graded intelligence test was higher in control group ( P < 0.01, P < 0.05) . We conclude that hyperbilirubinemia has negative influence on the nervous behavior and prognosis of neonates, and it should be treated actively.