早产儿高胆红素血症的诊疗进展

黄佳; 吴运芹; 高喜容

doi:10.11852/zgetbjzz2017-25-09-14

PDF(569 KB)

中国儿童保健杂志 ›› 2017, Vol. 25 ›› Issue (9) : 910-909. DOI: 10.11852/zgetbjzz2017-25-09-14

综述与讲座

早产儿高胆红素血症的诊疗进展

黄佳^1,2,吴运芹²,高喜容²

作者信息 +

Progress in diagnosis and treatment of hyperbilirubinemia in premature infants

HUANG Jia^1,2,WU Yun-qin²,GAO Xi-rong²

Author information +

文章历史 +

摘要

早产儿出生时胎儿红细胞数比例高,早期大量胎儿红细胞破坏,胆红素来源增加,肝脏功能不成熟,其摄取、结合、排泄胆红素功能差,易出现高胆红素血症。对于胎龄≥35周的新生儿,已有相应的光疗曲线及小时胆红素列线图作为诊断或干预标准,而胎龄<35周的早产儿尚缺乏公认的干预指南。本文就早产儿高胆红素血症的最新诊断和治疗进展进行综述。

Abstract

Preterm born with a high proportion of fetal red blood cells would have,a large number of early fetal red blood cell damaged,and increased bilirubin source.Moreover preterms liver function is immature.And its poor intake,utitization and excretion of bilirubin dysfunction,makes preterms prone to hyperbilirubinemia.For neonates with gestational age over 35 weeks,the corresponding phototherapy curve and the hourly bilirubin line chart have been used as diagnostic or intervention criteria.However preterm infants with gestational age less than 35 weeks still lack an accepted intervention guideline.This article reviews the latest diagnosis and treatment of hyperbilirubinemia in premature infants.

导出引用

黄佳,吴运芹,高喜容. 早产儿高胆红素血症的诊疗进展[J]. 中国儿童保健杂志. 2017, 25(9): 910-909 https://doi.org/10.11852/zgetbjzz2017-25-09-14

HUANG Jia,WU Yun-qin,GAO Xi-rong. Progress in diagnosis and treatment of hyperbilirubinemia in premature infants[J]. Chinese Journal of Child Health Care. 2017, 25(9): 910-909 https://doi.org/10.11852/zgetbjzz2017-25-09-14

中图分类号： R179

参考文献

[1] Esfandiarpour B,Ebrahimi H,Karkan MF,et al.Neonatal exchange transfusion for hyperbilirubinemia in Guilan (the north province of Iran):a3-year experience[J].Turk J Pediatr,2012,54(6):626-631.
[2] Simkiss D,Martin R.Neonatal jaundice[J].Journal of Tropical Pediatrics,2012,58(5):339-340.
[3] Tomerak RH,Helal NF,Shaker OG,et al.Association between the specific UGT-1A1 promoter sequence Variant (c-3279T>G) and unconjugated neonatal hyperbilir-ubinemia[J].J Trop Pediatr,2016.doi:http://dx.doi.org/10.1093/tropej/fmw031
[4] Min JIANG,Jie LUO,Caiyun YANG,et al.Gene mutation in neonatal jaundice mutations in UGT1A1 and OATP2 genes[J].Indian J Pediatr,2016,83(7):723-725.
[5] Zhu J,Xu Y,Zhang G,et al.Total serum bilirubin levels during the first 2 days of life and subsequent neonatal morbidity in very low birth weight infants:Aretrospective review[J].Eur J Pediatr,2012,171(4):669-674.
[6] Morioka I,Iwatani S,Koda T,et al.Disorders of bilirubin binding to albuminand bilirubin-induced neurologic dysfunction[J].Seminars in Fetal and Neonatal Medicine,2015,20(1):31-36.
[7] Lamola AA,Bhutani VK,Du L,et al.Neonatal bilirubin binding capacity discerns risk of neurological dysfunction[J].Pediatric Research,2015,77:334-339.
[8] Tidmarsh GF,Wong RJ,Stevenson DK.End-tidal carbon monoxide and hemolysis[J].J Perinatol,2014,34:577-581.
[9] 容志惠,罗芳,马丽亚,等.基于智能手机应用软件拍照监测对新生儿高胆红素血症随访的意义[J].中华儿科杂志,2016,54(8):597-600.
[10] Güzolu N,Tandirciolu A,Aliefendiolu D.Management of hyperbilirubinemia in preterm infants in Turkey[J].Turk J Med Sci,2016,46:401-403.
[11] Maisels MJ,Watchko JF,Bhutani VK,et al.An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation[J].Journal of Perinatology,2012,32(9):660-664.
[12] Bratlid D,Nakstad B,Hansen TWR.National guidelines for treatment of jaundi-ce in the newborn[J].Acta Paediatr,2011,100(4):499-505.
[13] Van Imhoff DE,Dijk PH,Hulzebos CV,et al.Uniform treatment thresholds for hyperbilirubinemia in preterm infants:background and synopsis of a national gu-ideline[J].Early Hum Dev,2011,87:521-525.
[14] 中华医学会中华儿科杂志编辑委员会,中华医学会新生儿科学分会新生儿学组.新生儿高胆红素血症诊断和治疗专家共识[J].中华儿科杂志,2014,52(10):745-748.
[15] 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,2011:298.
[16] Wusthoff CJ,Loe IM.Impact of bilirubin-induced neurologic dysfunction on neurodevelopmental outcomes[J].Seminars in Fetal and Neonatal Medicine,2015,20(1):52-57.
[17] Radmacher PG,Groves FD.A modified bilirubin induced neurologic dysfunction (BIND-M) algorithm is useful in evaluating severity of jaundice in a resourcelimited setting[J].BMC Pediatrics,2015,15:28.
[18] Sar S,Yavuz A,Batur A,et al.Brain magnetic resonance imaging and magnetic resonance spectroscopy findings of children with kernicterus[J].Polish Journal of Radiology,2015,80:72-80.
[19] Akinpelu OV,Waissbluth S,Daniel SJ.Auditory risk of hyperbilirubinemia in term newborns:A systematic review[J].International Journal of Pediatric Otorhinolaryngology,2013,77:898-905.
[20] Azzopardi D.Clinical applications of cerebral function monitoring in n-eonates[J].Seminars in Fetal and Neonatal Medicine,2015,20(3):154-163.
[21] 罗芳,林慧佳,鲍毓,等.新生儿胆红素脑病急性期脑功能监测[J].中华儿科杂志,2013,51(3):221-226.
[22] Brites D.The evolving landscape of neurotoxicity by unconjugated bilirubin:role of glial cells and inflammation[J].Front Pharmacol,2012,3:88.
[23] Amin SB,Bhutani VK,Watchko JF,et al.Apnea in acute bilirubin encephalopathy[J].Seminars in Perinatology,2014,38(7):407-411.
[24] Morris BH,William OH,Tyson JE,et al.Agressive vs.conservative phototherapy for infants with extremely low birth weight[J].N EnglJ Med,2008,359:1885-1896.
[25] Valerie S.Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants[J].The Practising Midwife,2013,16(2):35-37.
[26] Ives NK.Management of neonatal jaundice[J].Paediatrics and Child Health,2015,25(6):276-281.
[27] Olusanya BO,Iskander IF,Slusher TM,et al.A decision-making tool for exchange transfusions in infants with severe hyperbilirubinemia in resource-limited settings[J].Journal of Perinatology,2016,36(5):338.
[28] Gomia M,Takagi Y,Morizane A,et al.Functional recovery of the murine brain ischemia modelusing human induced pluripotent stem cell-derivedtelencephalic progenitors[J].Brain Res,2012,1459(24):52-60.
[29] 屈素清,刘卫鹏,杨辉,等.人神经干细胞侧脑室移植治疗40例重度脑性瘫痪的临床疗效[J].中华行为医学与脑科学杂志,2015,24(7):615-618.
[30] Amini N,Vousooghi N,Hadjighassem M.Efficacy of human adipose tissue-derived stem cells on neonatal bilirubin encephalopathy in rats[J].Neurotox Res,2016,29:514-524.