高胆红素血症与新生儿自发性眨眼的关系研究

目的评估高胆红素血症对新生儿自发性眨眼的影响。方法采用新生儿行为神经(NBNA)评分法、5分钟眨眼试验,检测评估53例高胆红素血症新生儿,按小时胆红素值分为高胆1组(小时胆红素第75百分位值)和高胆2组(小时胆红素第95百分位值),在黄疸消退后重复上述两项测评,并与38例同日龄正常新生儿对照。结果 (1)高胆红素血症新生儿NBNA评分明显低于正常同日龄新生儿,且自发性眨眼明显增多,差异有统计学意义(P0.05)。(2)高胆红素血症新生儿在黄疸消退后,NBNA评分和自发性眨眼频率较黄疸高峰期有所恢复,结果差异有统计学意义(P0.01)。(3)黄疸消退后高胆1组与同日龄的正常新生儿比较,NBNA评分和5分钟自发性眨眼频率差异无统计学意义(P值均0.05)。而高胆2组NBNA总分包括原始反射、一般评估仍明显低于正常同龄新生儿(P0.01);自发性眨眼频率仍较同日龄新生儿增多(P0.05)。(4)黄疸消退后高胆1组的NBNA评分、自发性眨眼恢复较好,与高胆2组比较差异有统计学意义(P0.05)。结论高胆红素血症可影响新生儿的行为表现和自发性眨眼频率,其影响程度与黄疸严重度有关。

Influence of Hyperbilirubinemia on Spontaneous Eye-blinking in Newborns

Objective To evaluate the influence of hyperbilirubinemia on spontaneous eye - blinking in newborns. Methods Fifty -throe hyperbilirnbinemia newborns and thirty- eight normal newborns at the same age were examined by the NBNA score and 5 minutes eye-blinking test. The hyperbilirubinemia newborns were divided into two groups, hyperbilirubinemia I （including 33 cases： serum bilirubin 〉 75th percentile） and hyperbilirnbinemia I1 （including 20 cases： serum bilirnbin 〉 95th percentile）. After the fade away of jaundice, tests were repeated, and results of hyperbilirubinemia newborns were compared with those of normal newborns. Results （ 1 ） NBNA score of hyperbilirubinemia newborns was lower and the eye - blinking times was more than that of normal newborns. The differences between them were statistically significant. （2） After the fade away of jaundice, the NBNA score and 5 minutes eye -blinking test improved significantly（ P〈0. 01 ）. （3） After the fade away of jaundice, there were no significant differences of the NBNA score and 5 minutes eye - blinking test between the hyperbilirubinemia I and the normal newborns （ P〉 0. 05 ） , but the NBNA score including the primary reflex and general assessment in the hyperbilirnbinemia Ⅱ was still obviously lower than that in the normal newborns（ P〈0. 01 ）. The spontaneous eye - blinking frequency was much higher than that in the normal newborns （ P〈 0. 05 ）. （4） After the fade away of jaundice, the NBNA score and 5 minutes eye - blinking test in the hyperbilirubinemia I recovered better than those in hyperbilirubinemia Ⅱ with a significant difference （ P 〈 0. 05）. Conclusions Hyperbilirubinemia can influence behavioral expression and spontaneous eye-blinking frequency in newborns and its severity has some relationships with that of jaundice. It can be inferred that neurotoxicity of bilirubin may induce some dopamine sub - systems more active and sensitive, and rosuh in the behavioral changes of newborns.