新生儿窒息血清总胆红素动态变化与脑损伤的关系

目的探讨血清总胆红素在新生儿窒息中的动态变化及其与脑损伤的关系。方法收集2006年11月-2011年2月汕头大学医学院第二附属医院住院治疗的足月窒息新生儿58例（窒息组）和健康足月新生儿30例（对照组）,窒息组中轻度窒息33例,重度窒息25例,检测三组新生儿出生后1、3、5、7 d时血清总胆红素水平变化,并分析其与窒息后脑损伤的关系。结果出生后1、3、5、7 d,三组血清TBIL浓度变化趋势相似。各时间点血清TBIL浓度组间比较,重度窒息组在1 d时明显高于轻度窒息组和对照组（P〈0.05）,之后3、5、7 d时均明显低于轻度窒息组和对照组（P〈0.05）。脑损伤组新生儿血清TBIL浓度变化趋势与CT正常组相似,组间比较,出生后3、5、7 d时脑损伤组新生儿的血清TBIL浓度均明显低于CT正常组（P〈0.05）。结论监测血清胆红素浓度动态变化对预测窒息预后、指导治疗有重要意义。

Relationship Between Dynamic Variation of Serum Total Bilirubin (TBil) Level and Brain Damage in Neonatal Asphyxia

Objective To explore the dynamic changes of serum total bilirubin(TBil) level and the relationship between TBil level and brain damage in neonatal asphyxia. Methods Serum concentration of TBil was detected in 58 neonates with asphyxia including mild asphyxia group(n=33) and severe asphyxia group(n=25)] and 30 normal newborns(control group) by the method of ELISA on days 1,3,5 and 7 after birth.And the relationship between dynamic changes of serum total bilirubin(TBil) level and brain damage were analyzed. Results The changes of TBil level on days 1,3,5 and 7 after birth in the three groups were same.The concentration of TBil on day 1 after birth in severe asphyxia group was significantly higher than that in mild asphyxia group and control group(P<0.05),but the concentration of TBil on days 3,5 and 7 after birth in severe asphyxia group was significantly lower than that in mild asphyxia group and control group(P<0.05).The changes of TBil in brain damage group and in asphyxia group without brain damage were same.The concentration of TBil on days 3,5 and 7 after birth in brain damage group was significantly lower than that in asphyxia group without brain damage(P<0.05). Conclusions Monitoring the dynamic changes of TBil level has an important significance in predicting the prognosis of neonatal asphyxia and guiding the treatment.