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ABSTRACT. In jaundiced newborn infants, hemolytic disease is considered a risk factor for kernicterus due to the suspected competition between bilirubin and other hemoglobin breakdown products for albumin binding. We have studied the effect of hematin on bilirubin-albumin binding using the peroxidase assay and a light-scattering technique for measuring unbound bilirubin. Our results show that hematin does not affect bilirubin-albumin binding. To determine if other albumin binding functions are affected by hematin, we used a microdialysis rate technique employing two ligands, diazepam and monoacetyldiaminodiphenyl sulfone (MADDS). Hematin does not utilize the diazepam binding function of albumin, but does decrease the albumin binding of MADDS. The results of this study indicate that the MADDS and bilirubin binding functions are not identical. The clinical usefulness of reserve albumin equivalent determination using MADDS is discussed. 相似文献
64.
反相高效液相色谱法测定体外培育牛黄中胆红素的含量 总被引:3,自引:1,他引:3
目的建立反相高效液相色谱法测定体外培育牛黄中胆红素的含量。方法固定相:HypersilC18色谱柱(4.6mm×250mm,10μm);流动相:二甲基亚砜-乙腈-0.5mol.L-1醋酸铵溶液(用冰醋酸调节pH值为5.3)(6∶6∶7);流速1.0mL.min-1;检测波长:452nm。结果胆红素在0.028~0.450mg.mL-1的浓度范围内,线性关系良好(r=0.9999);胆红素平均回收率(n=9)分别为98.8%(RSD=0.68%),98.3%(RSD=1.55%),99.0%(RSD=0.77%)。结论该含量测定方法快速,准确,有效,可用于体外培育牛黄的质量控制。 相似文献
65.
66.
冠心病患者血清胆红素和尿酸的变化及相关性 总被引:1,自引:0,他引:1
目的:观察冠心病患血清胆红素,尿酸含量变化及其临床意义。方法:采用比色法及酶法测定39例冠心病患及30例健康(对照组)血清胆红素,尿酸含量。结果:冠心病患血清直接胆红素,尿酸含量较对照组明显升高(P<0.01),血清间接胆红素含量明显低于对照组(P<0.01),血清总胆红素与对照组比较差异无显性(P>0.05);心肌梗死组血清总胆红素,直接胆红素,间接胆红素及尿酸含量与心肌缺血组比较无显性差异(P>0.05);心肌缺血组心功能Ⅲ-Ⅳ级患血清尿酸含量较心功能Ⅰ-Ⅱ级患升高显(P<0.05),血清总胆红素,直接胆红素,间接胆红素含量变化与心功能分级关系不明显;经相关分析,冠心病患血清总胆红素,直接胆红素,间接胆红素与尿酸含量间无相关性(P>0.05)。结论:胆红素,尿酸在冠心病的发病中可能起重要作用。 相似文献
67.
To determine the effect of skin pigments on transcutaneous bilirubinometer readings, we measured the effect of bilirubin, melanin, and oxyhemoglobin solutions on transcutaneous bilirubinometer readings in vitro. Our results showed that the variability of the readings in vitro was related to the instrument's non-linear response to bilirubin and melanin concentration and an inacurate oxyhemoglobin correction factor. These factors should be considered in developing a more accurate non-invasive method of monitoring serum bilirubin concentration. 相似文献
68.
Javid PJ Collier S Richardson D Iglesias J Gura K Lo C Kim HB Duggan CP Jaksic T 《Journal of pediatric surgery》2005,40(6):1015-1018
Background
Liver dysfunction in children dependent on parenteral nutrition (PN) is well established, and the extent of hyperbilirubinemia has been shown to correlate with morbidity and mortality. The aim of this study was to assess whether increasing provisions of enteral nutrition can improve PN-associated hyperbilirubinemia over time.Methods
A retrospective review was conducted on infants in our institution's Short Bowel Syndrome Clinic from 1999 to 2004. Inclusion criteria included PN duration more than 1 month, serum direct bilirubin more than 3 mg/dL while on PN, and tolerance of full enteral nutrition with eventual discontinuation of PN. Paired t tests were used for statistical analyses.Results
Twelve infants were identified with a PN duration of 5 ± 1 months. Five patients underwent liver biopsy while on PN, and histological evidence of cholestasis was found on all specimens. Peak total and direct bilirubin levels were 10.5 ± 1.9 and 7.0 ± 1.6 mg/dL, respectively, and occurred at time of PN discontinuation. Only 2 patients had improvement in serum bilirubin levels before initiation of full enteral nutrition. After initiation of full enteral nutrition and discontinuation of PN, all patients achieved permanent normalization of bilirubin levels by 4 months (P < .05) after a 1-month plateau phase. Alkaline phosphatase levels approached reference range within this time but were not significant.Conclusion
These data demonstrate for the first time that although PN-dependent infants can achieve normalization of marked hyperbilirubinemia with enteral nutrition, the improvement in liver function usually begins only after full enteral nutrition is tolerated and PN is withdrawn. These findings support the aggressive weaning of PN to enteral nutrition in infants with short bowel syndrome. 相似文献69.
Aim: To investigate whether inherited factors, other than those already known, influence the bilirubin concentration in neonates of northern European descent, by comparison of monozygotic and dizygotic twins with respect to differences in the plasma bilirubin concentrations between the twins. Methods: 77 healthy pairs of twins of the same gender with a gestational age ≥250 d and of northern European descent were included. Fourth postnatal day blood sampling was done. A multiple linear regression analysis was carried out with the difference in serum bilirubin concentration between the twins as the independent factor, and zygosity, gender, gestational age, postnatal age, maternal smoking, ABO blood-type incompatibility, and the differences between the twins in blood haemoglobin concentration, formula feeding and weight loss as dependent factors. Results: 27 pairs of twins were monozygotic and 50 pairs dizygotic. The analysis showed that the difference in serum bilirubin concentration between the twins was dependent on whether the twins were monozygotic or dizygotic, i.e. the estimated difference in serum bilirubin concentration between the monozygotic twins was 17.8 μmol l-1 [SE 6.6 μmol l-1, p = 0.02, 95% confidence interval (95% CI) 3.4, 32.3 μmol l-1] less than the difference between the dizygotic twins, adjusted for the above-mentioned potential confounders. The difference in serum bilirubin concentration between the twins was positively correlated to the difference in weight loss (%) between the twins (adjusted estimate 5.2 μmol l-1, SE 2.1 μmol l-1, p = 0.01, 95% CI 1.2, 9.3 μmol l-1).
Conclusion: In a population of northern European descent, other genetic factors than gender and ABO blood type were significant for the plasma bilirubin concentration in healthy infants. 相似文献
Conclusion: In a population of northern European descent, other genetic factors than gender and ABO blood type were significant for the plasma bilirubin concentration in healthy infants. 相似文献
70.
Seidman DS Paz I Armon Y Ergaz Z Stevenson DK Gale R 《Acta paediatrica (Oslo, Norway : 1992)》2001,90(3):292-295
The aim of this study was to evaluate the change in the treatment of neonatal jaundice following introduction of the "American Academy of Pediatrics' Practice Parameter for the management of hyperbilirubinemia in the healthy term newborn". In a historical control observation cohort study, we examined the rate of phototherapy and exchange transfusions among full-term (> or = 37 wk gestation) and near-term (gestational age between 35 and 37 wk and birthweight > 2000 g) infants in two community hospitals. The study included all consecutive infants born during two 15-mo study periods immediately before and after the introduction of the new guidelines. Data were prospectively recorded in a computerized database. The rate of phototherapy significantly decreased in the second study period from 7.9% (514/6499) to 2.9% (251/8650) (p < 0.0001) among full-term infants, and from 20.9% (102/489) to 9.4% (47/502) (p < 0.0001) in near-term infants. The use of exchange transfusion was significantly higher (p < 0.001) in the first compared to the second period: 0.2% (15/6499) vs 0.03% (3/8650). A significant decrease was found when the data from each hospital were analyzed separately. CONCLUSION: A significant decrease in the use of phototherapy and exchange transfusion occurred after the publication of the new practice parameters. This trend was observed for both term and preterm newborns, although the new guidelines were not intended for infants born before term. 相似文献