目的 探讨重度高胆红素血症的新生儿总胆红素/白蛋白的比值(B/A)与颅脑核磁(MRI)异常的关系及其临床意义。方法 对象为2013年1月-2014年1月收治的足月重度高胆红素血症(血清总胆红素≥342.2 μmol/L)162例,按照颅脑核磁结果,分为核磁检查正常组(126例)及核磁检查异常组(36例)。回顾性分析B/A比值与颅脑核磁的关系。结果 分析结果显示:颅脑核磁异常组较颅脑核磁正常组具有更高的B/A比值,差异具有统计学意义(P<0.05)。结论 高B/A比值是重度高胆红素血症患儿发生颅脑核磁异常的危险因素,可能导致患儿遗留神经行为后遗症,对于无条件行磁共振检查的基层医院通过观察B/A值,对高B/A重度高胆红素血症新生儿积极退黄疸尽可能减少其遗留神经系统后遗症的机率,并加强高危患儿的随访工作。
Abstract
Objective To investigate the relationship with neonatal hyperbilirubinemia between total bilirubin / albumin ratio(B/A)with brain magnetic resonance imaging (MRI) abnormalities and its clinical significance. Methods A total of 162 neonates hyperbilirubinemia (total serum bilirubin ≥342.2 μmol / L) between January 2013 and January 2014 enrolled in the study.They were divided into two groups,according to the Results of brain MRI:normal MRI group (n=126)and abnormal MRI group (n=36).Retrospective analysis of the relationship between B/A ratio of brain magnetic resonance imaging. Result The Results showed that the abnormal MRI group had a higher B/A ratio compared with the normal MRI group.it reached statistical significance (P<0.05). Conclusions High B/A ratio is a risk factor for abnormal MRI neonates with severe hyperbilirubinemia,which is the reason that could cause neurobehavioral sequelae of neonates.Primary hospital through observe B/A,high B/A ratiowith severe hyperbilirubinemia shoud active cut down jaundice,reduce neurobehavioral sequelae of neonates,enhance follow-up of high rise children.
关键词
重度高胆红素血症 /
颅脑核磁 /
B/A
Key words
hyperbilirubinemia /
magnetic resonance imaging /
B/A ratio
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:222-227.
[2] Esfandiarpour B,Ebrahimi H,Karkan MF,et al.Neonatal exchange transfusion for hyperbilirubinemia in Guilan (the north province of Iran):a 3-year experience[J].Turk J Pediatr,2012,54(6):626-631.
[3] 庄严,李贵南,周勇,等.重度高胆红素血症新生儿总胆红素/白蛋白比值及酸中毒与脑干听觉诱发电位异常的关系[J].中国当代儿科杂志,2013,15(5):332-336.
[4] Campistol J,Galvez H,Cazorla AG,et al.Neurological dysfunction induced by bilirrubin [J].Neurología,2012,27(4):202-211.
[5] Coskun A,Yikilmaz A,Kumandas S,et al.Hyperintense globus palliduson T1-weighted MRI imaging in acute kernicterus:is it common or rare[J].Eur Radiol,2005,15(6):1263-1267.
[6] Govaert P,Lequin M,Swarte RY,et al.Changes in globus palli-dus with (pre)term kernicterus[J].Pediatrics,2003,112(6 Pt1):1256-1263.
[7] 刘辉,潘家华,闵红,等.新生儿高胆红素血症总胆红素/白蛋白比值 与脑干听觉诱发电位的关系[J].临床儿科杂志,2012,29(9):841-844.
[8] 翁淑萍,施跃全,方如旗,等.新生儿急性胆红素脑病的核磁成像表现极其诊断价值[J].福建医科大学学报,2012,46(1):64-67.
[9] 廖伟华,王小宜,吴武林,等.MRII 鉴别新生儿缺氧缺血性脑病与急性胆红素脑病的价值[J].中国当代儿科志,2009,11(1):181-184.
[10] 杜琨,张路,吴玉芹,等.新生儿重度胆红素血症176例病因分析[J].中国中西医结合儿科学,2009,1(6):555-556.
[11] 吕峻峰,杨冰岩,王维琼,等.严重高胆红素血症新生儿急性胆红素脑病危险因素分析[J].中国新生儿科杂志,2014,29(4):242-246.