直接胆红素升高在新生儿感染诊断中的价值

目的探讨新生儿感染的诊断中检测直接胆红素的价值。方法回顾性分析于高唐县人民医院住院治疗的患感染性疾病的186例新生儿病例与100例高胆红素血症的病例,比较各组间胆红素水平。结果高胆红素血症与感染性患儿的入院时血清总胆红素（TBIL）均升高,但两组相比,感染性患儿直接胆红素（DBIL）和间接胆红素（IBIL）均升高,而高胆红素血症以IBIL升高为主;感染性疾病内各组间相比,感染性败血症、巨细胞病毒感染病例的TBIL值显著高于感染性肺炎和感染性肠炎病例的TBIL值（P〈0.01）;感染性肺炎、感染性败血症、巨细胞病毒感染、感染性肠炎的DBIL值均显著高于高胆红素血症患儿的DBIL（均P〈0.01）。经治疗后出院时各项数值均较前降低。结论 DBIL的升高在新生儿感染性疾病的诊断中有很大意义,应加强对新生儿血清TBIL、DBIL的检测。

Value of Increased Direct Bilirubin in the Diagnosis of Neonatal Infection

Objective]To study the value of direct bilirubin detection in the diagnosis of neonatal infection.Methods]186 cases of neonatal infection and 100 cases of hyperbilirubinemia in the People＇s Hospital of Gaotang County were analyzed retrospectively,and the bilirubin levels of different groups were compared.Results]The serum total bilirubin （TBIL） of children with infection and hyperbilirubinemia both increased on admission,but direct bilirubin （DBIL） and indirect bilirubin （IBIL） in the infection group both increased,and the hyperbilirubinemia group was dominated by increased IBIL. Among different infectious diseases,TBIL levels of children with infectious septicemia and cytomegalovirus infection was higher than that of children with infectious pneumonia and infectious enteritis significantly （P0.01）. DBIL level of children with infectious pneumonia,infectious septicemia,cytomegalovirus infection and infectious enteritis was higher than that of children with hyperbilirubinemia （all P0.01）. After treatment,the levels of indexes all decreased at discharged.Conclusion]Increased DBIL has great significance in the diagnosis of neonatal infectious diseases,and detection of serum TBIL and DBIL among newborn infants should be strengthened.