目的 通过对高胆红素血症新生儿血清激活素A(ACT A) 水平的检测,探讨血清ACT A在新生儿胆红素脑损伤的关系和临床意义。方法 应用ELISA方法检测61例足月高胆红素血症(高胆)新生儿和25例正常新生儿血清中ACT A浓度,同步测定血清总胆红素(total serum bilirubin,TSB),高胆组按血清TSB值221~256 μmol/L,257~342 μmol/L,>342 μmol/L分为轻、中、重度三组;对照组TSB<85 μmol/L。结果 轻、中、重度高胆患儿血清ACT A 浓度值分别是(3.68±0.62)μg/L,(4.32±0.53)μg/L,(5.12±0.71)μg/L ,较对照组明显升高(P<0.05);在轻、中、重度高胆患儿间,血清ACT A 浓度差异有统计学意义(P<0.05),其值随着胆红素升高而升高;血清ACT A浓度与胆红素呈正相关(r=0.82,P<0.01)。结论 内源性ACT A参与新生儿胆红素脑损伤的发病过程,其浓度与患儿血清胆红素的水平有关。

Objective To explore the relation of serum activin A (ACT A) in neonatal brain damage and its clinical significance in neonates with hyperbilirubinemia. Methods Serum levels of ACT A were measured using ELISA in 61 term neonates with hyperbilirubinemia and 25 normal term neonates.Meanwhile,The hyperbilirubinemia group was classified into three subgroups based on serum total serum bilirubin(TSB) levels in mild (221~256 μmol/L),moderate (257~342 μmol/L)and severe (>342 μmol/L).Serum TSB levels in the 25 normal neonates were less than 85 μmol/L (control group). Results ACT A levels in the mild,moderate and severe hyperbilirubinemia groups[(3.68±0.62),(4.32±0.53) and (5.12±0.71) μg/L,respectively] were obviously higher than those in the control group(P<0.05).There were significant differences among the three hyperbilirubinemia sub groups in serum ACT A levels (P<0.05).And it increased with the increase of bilirubin.Serum ACT A levels were positively correlated to the bilirubin(r=0.82,P<0.01). Conclusion Activin A levels is associated with bilurubin-induced brain damage and correlated to the level of serum bilirubin.