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1.
红细胞葡萄糖 6 -磷酸脱氢酶 (G- 6 -PD)缺陷症是一种常见的遗传性疾病 ,是新生儿高胆红素血症的常见原因之一。为了调查新生儿期 G- 6 - PD缺陷引起高胆红素血症的围产因素 ,现将 1997年 1月~ 1998年 12月我科收治的新生儿G- 6 - PD缺陷合并高胆红素血症的围产因素进行分析 ,  相似文献   

2.
新生儿脐血红细胞葡萄糖6磷酸脱氢酶缺乏筛查结果分析   总被引:4,自引:0,他引:4  
目的 了解广东省东莞市莞城地区新生儿脐血红细胞葡萄糖6磷酸脱氢酶(G-6-PD)缺乏的发生率。方法 9676例活产新生儿生后即取脐血,采用定量法测定红细胞G6PD/6PGD的比值。低于1.0者为G-6-PD缺乏。结果 测得G-6-PD缺乏的患儿265例,总发生率为2.74%。其中男230例,发生率为4.07%;女35例,发生率为0.87%。男性发生率明显高于女性(χ^2=90.75,P<0.001)。结论 脐血G-6-PD活性筛查,能比较准确地检测出G-6-PD缺乏患儿,指导临床对其并发症进行早期干预,避免智力低下等后遗症的发生,提高人口素质。  相似文献   

3.
目的研究葡萄糖 6 磷酸脱氢酶(G6PD)缺乏的新生儿高胆红素血症发生率及发病特点。方法对近5年来中山市陈星海医院产科分娩的足月健康新生儿脐带血进行G6PD定量测定,对G6PD活性缺乏的患儿,按性别和酶活性缺乏的程度分组调查其高胆红素血症的发生率及发病时间。结果(1)418例G6PD活性缺乏的患儿共发生高胆红素血症82例,占19.62%。(2)在G6PD活性缺乏的患儿中,男性酶的活性极显著低于女性(P<0.01);高胆红素血症的发生率男性极显著高于女性(P<0.01);酶活性缺乏程度不同的3组患儿高胆红素血症发生率有显著差别(P<0.05);G6PD活性缺乏的患儿发生高胆红素血症的时间主要在出生后的1周内。结论在新生儿期,G6PD活性缺乏的患儿高胆红素血症的发生率较高,发病具有男性多于女性、酶活性缺乏程度越重高胆红素血症的发生率越高的特点,患儿发生高胆红素血症的高峰时间在出生后的2~4d。  相似文献   

4.
新生儿葡萄糖6-磷酸脱氢酶缺陷症基因突变分析与临床   总被引:1,自引:0,他引:1  
目的 分析红细胞葡萄糖6—磷酸脱氢酶(G—6—PD)缺陷症新生儿的基因型,探讨基因突变型与临床表现之间可能的关系。方法 应用特异性多聚酶链反应分析方法,分析36例新生儿G—6—PD缺陷症的G1388A,G1376T,A95G基因突变型。结果 在36例G—6—PD缺陷症患儿中G1388A 23例(64%),G1376T 13例(36%),无A95G突变。前两种基因突变型所致的临床表现无明显差别,均引起新生儿急性溶血性贫血和黄疸。结论 G1388A和G1376T为新生儿常见G—6—PD基因突变型,对黄疸高危新生儿,建议有条件的医院尽可能做G—6—PD缺陷症常规筛查。  相似文献   

5.
红细胞葡萄糖-6-磷酸脱氢酶(glucose-6-phosphate de-hydrogenase,G-6-PD)缺陷病是一种常见的不完全显性伴性遗传病,主要表现为溶血性贫血和由此产生的高胆红素血症,通常新生儿期发病,病情凶险,易引起胆红素脑病,严重危害新生儿健康和生命。我院自2000年1月至2006年9月共收治红细胞G-6-PD缺陷病新生儿52例,现总结报道如下。  相似文献   

6.
目的:通过对新生儿葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症的筛查,了解钦州市G6PD缺乏症的发病情况。方法:采用速率法对新生儿脐血进行G6PD缺陷筛查。结果:钦州市G6PD筛查95473例,缺乏4011例,G6PD缺乏症总发生率为4.20%;男婴2513例,占男性受检人数的5.10%(2513/49252),其中中度缺乏645例,占1.31%(645/49252),重度缺乏1868例,占3.79%(1868/49252);女婴1498例,占女婴受检人数的3.24%(1498/46221),其中中度缺乏1303例,占2.82%(1303/46221),重度缺乏195例,占0.42%(195/46221)。结论:钦州市新生儿G6PD缺乏症发生率较高,男性患者明显多于女性患者,男性多为重度缺乏,女性多为中度缺乏。  相似文献   

7.
β-葡萄糖醛酸苷酶测定对新生儿母乳性黄疸的诊断价值   总被引:6,自引:0,他引:6  
目的 探讨β-葡萄糖醛酸苷酶与母乳性黄疸的关系,以及母乳和粪便β-GD测定在母乳性黄疸诊断上的意义。方法 采用酶学比色法对47例母乳性黄疸及60例正常新生儿母率。结果 黄疸组母乳及粪便β-GD活性浓度(1.363±0.299U/L及1.071±0.297U/L)较正常组(0.746±0.325U/L及0.496±0.276U/L)明显增高,两组之间具有极显著差异。  相似文献   

8.
Cai LQ  Li M  Lu S  Wang HB  Wang ZH 《中华妇产科杂志》2004,39(7):478-481,i004
目的 观察谷胱甘肽 S 转移酶P1(GSTP1)启动子调控的胞嘧啶脱氨酶和尿嘧啶磷酸核糖转移酶融合基因 (CD UPP ,即自杀基因 )表达的腺病毒载体 ,对卵巢癌顺铂耐药细胞的体外杀伤作用。方法 采用细菌内同源重组法构建腺病毒载体 ,设立卵巢癌顺铂敏感细胞株A2 780和以其诱导的耐药细胞株A2 780 /DDP ,在体外用重组腺病毒转染两组细胞并联合应用前药 5 氟胞嘧啶 (5 FC) ,观察两组卵巢癌细胞对 5 FC的敏感性。将CD UPP阳性和CK UPP阴性的A2 780 /DDP细胞按不同比例混合后给予 5 FC ,观察 5 FC对混合细胞的杀伤作用。结果 当重组腺病毒滴度为 10 0感染复数(MOI)、5 FC浓度为 2 5 0 μg/ml时 ,对顺铂耐药的A2 780 /DDP细胞的存活率为 (3 6± 1 0 ) % ,对顺铂敏感的A2 780细胞的存活率为 (76 5± 2 8) % ,两者比较 ,差异有显著性 (P <0 0 5 )。此外 ,2 0 ? UPP阳性A2 780 /DDP细胞 ,即可引起 80 3%的混合细胞死亡 ,CD UPP / 5 FC系统表现出明显的旁观者效应。结论 由腺病毒介导的含有GSTP1调控的CD UPP/ 5 FC系统 ,对卵巢癌顺铂耐药细胞具有特异性杀伤作用 ,为临床上克服卵巢癌化疗耐药 ,提供了一条安全、高效的治疗途径。  相似文献   

9.
目的 探讨新生儿高胆红素血症(简称高胆)时T淋巴细胞亚群和血清可溶性白细胞介素-2受体(soluble interleukin-2 receptor,sIL-2R)水平的变化趋势及其临床意义.方法 选择2006年12月1日至2007年1月31日住院的31例高胆新生儿作为高胆组,再根据黄疸程度分为重度黄疸组和轻度黄疸组;将其中16例随访病例按照病程分为黄疸高峰期与黄疸恢复期.选取同期与高胆组日龄相匹配的32例健康足月新生儿(无黄疸或血清胆红素水平≤204.0 μmol/L)作为与高胆组相对应的对照组(对照组Ⅰ);选取同期与黄疸恢复期病例日龄相匹配的26例健康足月新生儿(日龄>7 d)作为与随访病例相对应的对照组(对照组Ⅱ).采用方差分析及两两检验比较各组血清胆红素、T淋巴细胞亚群、sIL-2R水平,并分析其间的相关性.结果 高胆组新生儿的CD3、CD4、CD4/CD8比值分别为(54.0±5.1)%、(26.8±5.0)%和0.8±0.1,较对照组Ⅰ[(62.0±4.7)%、(43.0±4.7)%和1.4±0.2]降低(P<0.01);而黄疸恢复期较黄疸高峰期增高[(62.4±3.3)%和(55.1±4.2)%、(43.6±2.5)%和(26.1±4.4)%、1.4±0.1和0.8±0.1](P<0.01);黄疸高峰期血清sIL-2R水平[(319.4±185.2)kU/L]高于黄疸恢复期[(129.7±99.3)kU/L]和对照组Ⅱ[(171.9±102.2)kU/L](P<0.01).总体的血清胆红素水平与CD4/CD8比值呈负相关(r=-0.99,P<0.01),与sIL-2R水平呈正相关(r=0.95,P<0.05),sIL-2R水平与CD4/CD8比值呈负相关(r=-0.92,P<0.05).结论 新生儿高胆时存在细胞免疫功能抑制状态,该抑制状态有随着黄疸消退而逐渐减轻的趋势.
Abstract:
Objective To investigate the dynamic changes and the clinical significance of T-cell subsets and serum soluble interleukin-2 receptor (sIL-2R)in neonates with hyperbilirubinemia.Methods Thirty-one neonates with hyperbilirubinemia, admitted to the hospital from Decembr 1,2006 to January 31, 2007, were enrolled and divided into two subgroups: severe jaundice group and mild jaundice group according to the bilirubin level. Thirty-two age-mached healty newborns were as controls(control group Ⅰ). The T-cell subsets and sIL-2R of peripheral venous blood samples from these neonates were measured and compared. Sixteen of these 31 neonates with hyperbilirubinemiawere followed up and another twenty-six age-mached healty newborns were as controls(control group Ⅱ ). The level of serum bilirubin in convalescence of sixteen hyperbilirubinemia neonates and control group Ⅱ were tested and analyzed also. Results The levels of CD3, CD4, CD4/CD8 in the neonates with hyperbilirubinemia were lower compared with those of control group Ⅰ [(54.0±5.1)% vs (62.0±4.7)%, (26.8±5.0)% vs (43.0±4.7)%, 0.8±0.1 vs 1.4±0.2] (P<0.01), but was higher in convalescence than in peak phase[ (62.4±3.3)% vs (55.1±4.2)%, (43.6±2.5)% vs (26.1±4.4)%, 1.4 ± 0.1 vs 0.8±0.1] (P<0.01). The peak level of sIL-2R in the hyperbilirubinemia group was (319.4± 185.2) kU/L, higher than that in the convalescence [(129.7±99.3) kU/L] and in the control group Ⅱ [(171.9±102.2) kU/L] (P<0.01). The serum bilirubin level showed negative correlation with CD4/CD8 ( r = -0.99, P < 0.01 ) and positive correlation with sIL-2R (r=0.95, P<0.05). The sIL-2R level was negatively correlated with CD4/CD8 (r=-0.92, P<0.05). Conclusions Neonates, when suffering from hyperbilirubinemia, are immunosuppressed which may recover with the alleviation of jaundice.  相似文献   

10.
目的 :研究溶脲脲原体 ( ureaplasma urealyticum,UU)对大鼠睾丸支持细胞分泌 IL- 1 α和 IL- 6的影响。方法 :2 0 d龄雄 SD大鼠 8只 ,无菌取睾丸 ,经 型胶原酶和透明质酸酶消化 ,分离出纯度较高的支持细胞 ,用 DMEM/Ham's F- 1 2培养液培养。实验组加入 UU一起培养 ,对照组则加 UU培养基。分别取培养 1~ 4d的细胞上清液 ,用 ELISA法检测其 IL- 1α和 IL- 6的含量。结果 :实验组与对照组相比 ,IL- 1α的含量显著降低 ( P<0 .0 1 ) ,IL- 6的含量显著升高 ( P<0 .0 1 )。结论 :UU感染使支持细胞分泌 IL- 1 α减少 ,却明显促进 IL- 6的分泌。提示 UU感染与生殖道 (腺 )局部免疫有关  相似文献   

11.
OBJECTIVE: To ascertain the effect of isotonic saline and glucose infusions of oxytocin on neonatal bilirubin levels. METHOD: Eighty-two parturient Nigerian women requiring oxytocin infusion in labor were randomized into two groups receiving 0.9% saline or 5% glucose, respectively. A group of 82 women not requiring oxytocin were recruited for comparison. All had sodium and bilirubin estimations in cord plasma and neonatal bilirubin assay on Day 3. RESULT: Analysis of variance revealed higher mean cord and neonatal bilirubin levels in the glucose group compared with the other two (P < 0.05). Significant inverse correlation was observed between cord plasma sodium and neonatal bilirubin levels in all groups. Hyperbilirubinemia occurred in 55% of babies in the glucose group compared with 21% and 22% in the saline and control groups, respectively (P < 0.001). CONCLUSION: The use of isotonic saline rather than 5% glucose solution as vehicle for oxytocin infusion in labor appears to be associated with lower neonatal bilirubin levels.  相似文献   

12.
Objective.?Nonphysiologic hyperbilirubinemia of unexplained cause is prevalent among Turkish newborns, suggesting that there might be genetic risk factors in this population. Mutation of the UGT1A1 gene, glycine to arginine at codon 71 (G71R), is related to the development of neonatal jaundice in East Asian populations but the frequency of this mutation is rare among Caucasian populations. There are insufficient data on the G71R mutation in Turkish newborns with hyperbilirubinemia. The aim of this study was to investigate the genotypic distribution of the G71R mutation and its relationship with nonphysiologic hyperbilirubinemia of unexplained cause in Turkish newborns.

Methods.?Polymerase chain reaction, restriction fragment length polymorphism and agarose gel electrophoresis techniques were used for detection of G71R mutation in 109 newborn infants: 39 with hyperbilirubinemia and 70 without hyperbilirubinemia.

Results.?The genotypic distribution for the mutation was 70 G/G, 32 A/G, 7 A/A genotypes and the mutated allele frequency was 0.22. The frequency of G71R mutation was 33.3 % (n?=?13) A/G, 7.7% (n?=?3) A/A in the hyperbilirubinemia group and 27.1% (n?=?19) A/R, 5% (n?=?4) A/A in the nonhyperbilirubinemia group. The difference between the groups was not statistically significant.

Conclusions.?Our results suggest that G71R mutation of UGT1A1 is not rare; however, an association between G71R mutation and hyperbilirubinemia of unexplained cause has not been shown in Turkish newborns.  相似文献   

13.
Objective: The associations between Gly71Arg polymorphism in the coding region of uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene and the risk of neonatal hyperbilirubinemia remained controversial. Therefore, a meta-analysis of observational studies has been conducted to assess the relationship between UGT1A1 gene polymorphism of Gly71Arg and neonatal hyperbilirubinemia susceptibility.

Methods: An electronic literature search from online databases, such as PubMed, Embase, Cochrane, and Scopus was conducted to identify eligible studies. The effect summary odds ratio (OR) with 95% confidence interval (CI) was used to estimate the strength of association in the fixed or random effects model, based on the absence or presence of heterogeneity.

Results: A total of 32 eligible studies involving 2634 cases of neonatal hyperbilirubinemia and 4996 controls were enrolled in this meta-analysis. The combined results showed that UGT1A1 Gly71Arg polymorphism was associated with an increased risk of neonatal hyperbilirubinemia in all genetic models (homozygote model: OR?=?6.12, 95% CI?=?4.42–8.46; heterozygote model: OR?=?2.06, 95% CI?=?1.82–2.33; dominant model: OR?=?2.44, 95% CI?=?2.03–2.93; recessive model: OR?=?4.79, 95% CI?=?3.48–6.59, and allelic model: OR?=?2.37, 95% CI?=?1.98–2.82). Subgroup analysis by ethnicity strongly validated this correlation in Asians but slightly in Caucasian population.

Conclusions: This meta-analysis confirms that UGT1A1 Gly71Arg polymorphism significantly increases the risk of neonatal hyperbilirubinemia in Asian population, but results from the Caucasians were conflicting and further well-designed epidemiological studies are, therefore, required to more adequately assess this correlation.  相似文献   

14.
Objective: Jaundice is a problem in newborns. There are many maternal and infant-related factors affecting neonatal jaundice. The maternal pre-pregnancy weight, maternal body mass index (BMI) and gestational weight gain may have an effect on the newborn bilirubin levels. We research the effect of the maternal pre-pregnancy weight and gestational weight gain on the bilirubin levels of the newborn infants in the first 2 weeks prospectively.

Methods: Term and healthy infants who were born between 38 and 42 weeks in our clinic were included in the study. Maternal pre-pregnancy BMIs were calculated. Babies were divided into three groups according to their mothers’ advised amount of gestational weight gain. Total serum bilirubin (TSB) values of the newborns were measured in the 2nd, 5th and 15th postnatal days.

Results: In our study, the 5th and 15th day capillary bilirubin level of the babies with mothers who gained more weight than the advised amount during pregnancy were found statistically significant higher compared to the other two groups (p?<?0.05). Similarly, the hematocrit level of the babies with mothers who gained more weight than the advised amount were found statistically significant higher compared to the other two groups (p?<?0.05).

Conclusions: We conclude that the babies with mothers who gained more weight than the advised amount were under risk for newborn jaundice. Therefore, these babies should be monitored more closely for neonatal jaundice and prolonged jaundice.  相似文献   

15.
Objective: To investigate the relationship of neonatal bilirubin levels to oxytocin infusion and the diluent used for oxytocin infusion. Materials and methods: The study was carried out as a prospective, randomized study in Istanbul University Cerrahpasa School of Medicine,Department of Obstetrics and Gynecology between January to December in 1995 . A total of 80 patients managed with oxytocin during labor, enrolled to the study. These patients randomly divided into isotonic % 0.9 saline (Group 1) and 5% glucose solutions (Group 2) by a consecutive order using a balanced block randomization scheme. Forty multiparous patients delivering without oxytocin infusion formed the control group (Group 3). The details of maternal age, gestational age, labor duration, mode of delivery, birth weight of the babies, total volume of fluid administered until delivery and total oxytocin dose were noted in each case. Sodium and initial bilirubin levels were measured in the cord blood. Later on, capillary blood bilirubin and hematocrit concentrations were measured on day 1 and 2 in the newborn nursery. The groups were compared according to these parameters. Results: The data of 29 patients in Group 1, 36 patients in Group 2 and 40 patients in Group 3 were suitable for analysis. The difference between study and control groups regarding the rate of hyponatremia, neonatal hyperbilirubinemia and neonatal jaundice was not statistically significant. Cord plasma sodium levels, cord plasma bilirubin levels and day 1 and 2 hematocrit and plasma bilirubin levels were not statistically different between the groups. Unrespectable of the diluent used, the cord plasma bilirubin levels and day 2 plasma bilirubin levels were significantly higher in the accelerated group. Conclusion: No significant effect of oxytocin infusion was revealed on neonatal hyperbilirubinemia unless oxytocin was for the augmentation of labor. Received: 15 October 2001 / Accepted: 5 January 2002  相似文献   

16.
Abstract

Objective: The etiology of jaundice in otherwise healthy breastfed newborns that can present as early-onset exaggerated physiologic jaundice, or late breast milk jaundice (BMJ), is not yet entirely understood. This study tested the hypothesis that molecular marker for Gilbert's syndrome (GS), UGT1A1 TATA-box polymorphism, is associated with this disorders.

Methods: We have investigated the UGT1A1 polymorphism frequency and its relation to severity of hyperbilirubinemia and jaundice duration among 220 exclusively breastfed term newborns; 57 of them with non-physiologic hyperbilirubinemia (NH), and 163 with BMJ, and in 187 healthy controls.

Results: Significant differences in TA7/7 genotype frequency were established. The highest frequency was observed among the newborns with BMJ (42.0%), intermediate in the NH group (24.6%), while the controls had the lowest TA7/7 frequency (12.8%). Linear increase in TA7/7 frequency was observed depending on the duration of jaundice, peaking at 42.4% in newborns with the longest jaundice duration. Positive correlation between the serum bilirubin levels and the TATA-box length was established in all groups.

Conclusion: This study provides evidence that UGT1A1 TATA-box polymorphism is an important risk factor for developing jaundice in term breastfed newborns, presented as either early non-physiologic hyperbilirubinemia or breast milk jaundice. These results further support the original Odell's idea of neonatal jaundice as an early presentation of GS.  相似文献   

17.
目的观察茵栀黄颗粒、双歧杆菌四联活菌片及苯巴比妥片联合蓝光照射治疗早期新生儿黄疸的临床效果。方法 2014年1月至12月解放军第四〇四医院儿科收治新生儿黄疸患儿192例,随机分为二联疗法组、三联疗法组、四联疗法组各64例。二联疗法组给予口服茵栀黄颗粒和双歧杆菌四联活菌片;三联疗法组在二联疗法组基础上给予口服苯巴比妥片;四联疗法组在三联疗法组基础上联合蓝光照射治疗。3组各治疗5~7d,观察治疗后7d经皮胆红素值的变化。结果 3组患儿治疗前、治疗第1~3天经皮胆红素水平比较,差异无统计学意义(P0.05)。3组患儿治疗第4~7天经皮胆红素水平比较,差异有统计学意义(P0.05),其中四联疗法组经皮胆红素水平较二联疗法组、三联疗法组显著减低,差异有统计学意义(P0.01),三联疗法组经皮胆红素水平较二联疗法组显著减低,差异有统计学意义(P0.05)。四联疗法组总有效率为98.4%(63/64),显著高于二联疗法组76.6%(49/64)和三联疗法组81.2%(51/64),差异有统计学意义(P0.017),二联疗法组和三联疗法组总有效率比较差异无统计学意义(P0.017)。3组均未发生不良反应。结论早期联合使用茵栀黄颗粒、双歧杆菌四联活菌片、苯巴比妥配合蓝光照射治疗新生儿黄疸疗效肯定。  相似文献   

18.
目的 探讨细胞色素P450 (cytochrome P450, CYP)1A1 基因MspⅠ位点和硫酸氨基转移酶(sulfotransferase, SULT) 1A1 基因 Arg213His位点多态性与鲁北地区汉族女性子宫肌瘤的关系。 方法 采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)方法检测123例子宫肌瘤患者和123例健康对照组的CYP1A1 基因 MspⅠ位点的基因型和SULT1A1 基因 Arg213His位点的基因型,分析基因多态性与子宫肌瘤的关系。 结果 子宫肌瘤组CYP1A1基因MspⅠ位点的基因型与对照组中的分布比较,差异无统计学意义(P=0.927); 而子宫肌瘤组SULT1A1 基因Arg213His位点的基因型与对照组中的分布比较,差异有统计学意义( P=0.011)。CYP1A1基因MspI位点和SULT1A1基因Arg213His位点多态性在子宫肌瘤的发生过程中的交互作用比较,差异有统计学意义( P=0.024 )。 结论 CYP1A1 基因MspⅠ位点多态性与鲁北地区汉族女性子宫肌瘤的易感性无显著相关;SULT1A1 基因Arg213His位点多态性与鲁北地区汉族女性子宫肌瘤的发生有关,并增加了子宫肌瘤的患病风险;CYP1A1基因MspI位点和SULT1A1基因Arg213His位点多态性在子宫肌瘤的发生过程中具有交互作用。  相似文献   

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Objective: We investigated the effect of kangaroo mother care (KMC) on the duration of phototherapy of jaundiced neonates. Methods: Fifty Egyptian newborns hospitalized for jaundice were investigated through a prospective observational study to determine whether intermittent KMC would reduce the duration of phototherapy required. Results: The babies who received KMC recovered earlier from jaundice and needed a shorter duration of phototherapy than the control group (68.14?±?24.32 hour versus 100.86?±?42.26 hour, p?=?0.004). Conclusion: KMC may be an effective intervention to reduce the duration of phototherapy needed when jaundiced babies are hospitalized.  相似文献   

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