摘要
目的分析足月儿胆红素脑病的临床特点并探讨后遗症的影响因素。方法收集我科2008年1月1日至2012年1月1日确诊的足月新生儿胆红素脑病82例,分析临床资料,血清总胆红素(TSB)峰值、总胆红素/白蛋白(B/A)比值、部分新生儿行为评分(NBNA)、脑干诱发电位(BAEP)、随访结果等。结果 (1)胆红素脑病发病日龄为(4±3)天,其中≤7天者占90%,警告期49例(60%),痉挛期33例(40%)。(2)主要病因为新生儿Rh血型不合溶血病50例(60%),感染性疾病例25例(31%),ABO血型不合溶血病15例(18%)。(3)痉挛期组TSB为(560±130)μmol/L,警告期TSB为(430±70)μmol/L,二者比较差异有显著性。痉挛期组B/A比值(8.8±2.1)mg/g高于警告组的(6.8±1.5)mg/g,差异有显著性(P<0.05)。结论 (1)胆红素脑病发病日龄≤7天多见。(2)新生儿Rh溶血病是新疆地区引起胆红素脑病的主要病因。(3)TSB及B/A比值与胆红素脑病的程度呈正相关。(4)45例行NBNA评分,NBNA<35分24例,其中警告期3例(13%),痉挛期21例(88%),二者比较差异有显著性(P<0.05);50例行BAEP,BAEP异常率为53%,表现形式多样。(5)随访41例,10例发生后遗症,有后遗症组与无后遗症组平均TSB差异有显著性(P<0.05),B/A比值比较差异无显著性。
Objectives The study was designed to analyze the clinical features of bilirubin encephalopathy(BE) in newborns and explore the possible factors that affect the sequelae of patients.Methods Data of 82 newborns suffering from BE were collected from January 1, 2008 to January 1, 2012 and retrospectively analyzed. The clinical features were summarized and the serum total bilirubin, total bilirubin / albumin(B/A)ratio of them were analyzed. The results of the neonatal behavioral score(NBNA), brain stem auditory evoked potential(BAEP), and follow-up results were analyzed. Results(1) In this study, the age BE onset was(4±3) days, with 74 cases(90%) having BE at the age of ≤ 7 days. There were 49 cases(60%) in warning period and 33 cases(40%) in spasmodic of the illness.(2) Fifty cases(60%) suffered from Rh hemolytic disease, 25(31%) infectious diseases and 15(18 %) ABO hemolytic disease.(3) The mean TSB in the warning period group was(430±70)μmol / L, while it was(560±130) μmol /L in the spasmodic period group. The mean B/A in the warning period group was(6.8±1.5)mg /g, while it was(8.8±2.1)mg / g in the spasmodic period group with a significantly statistical difference.Conclusion(1) Infants at the age ≤ 7d are easier to have BE.(2) RH hemolytic disease is one of the major factors to BE.(3) TSB and B / A ratio have a positive collection with the extent of bilirubin encephalopathy.(4) In the 45 cases having NBNA examinations, 24 had points less than 35. There were 3 cases(13%) in the warning period while 21 cases(88%) in the period of spasticity. Fifty cases had BAEP examinations with an abnormality rate of 53%.(5) In the 41 cases that had a follow up, 10 had sequelae. Between the group with sequelae and that without sequelae.
出处
《发育医学电子杂志》
2013年第3期150-154,共5页
Journal of Developmental Medicine (Electronic Version)
关键词
胆红素脑病
病因
临床特征
后遗症
Bilirubin encephalopathy
Etiology
Clinical features
The prognosis
