高胆红素血症新生儿血清S-100蛋白及总胆红素与白蛋白比值的变化及意义

目的 研究高胆红素血症(高胆)新生儿血清S-100蛋白水平和总胆红素(TBC)与白蛋白(B/A)比值的变化,为早期预测胆红素脑损伤提供新的方法.方法 根据胎龄、体质量和是否符合黄疸干预标准将出生7 d内的84例新生儿分为足月高胆组、足月对照组、早产高胆组、早产对照组.检测4组血清S-100蛋白、TBC、白蛋白水平,计算B/A比值.结果 足月高胆组S-100蛋白含量[(0.36±0.14)μg/L]高于足月对照组[(0.25±0.07)μg/L],差异有显著性(P＜0.05),足月高胆组S-100蛋白含量与B/A比值呈正相关性(r=0.509,P＜0.05).早产高胆组S-100蛋白含量[(0.40±0.09)μg/L)高于早产对照组[(0.28±40.05)μg/L],差异有显著性(P＜0.05),S-100蛋白含量与B/A比值无相关性(r=0.356,P＞0.05).结论 血清S-100蛋白和B/A比值可作为早期预测胆红素神经毒性的敏感指标.

Changes and significance of serum S-100 protein and B/A ratio in neonates with hyperbilirubinemia

Objective To evaluate the significance of S-100 protein and B/A for early predicting the brain damage caused by neonatal hyperbilirubinemia. Methods According to the gestational age, birth weight and the intervention criterion of neonatal jaundice,84 newborns were divided into 4 groups. Group A (n =22) were term infants with unconjugated hyperbilirubinemia. Group B( n = 22) were control group of term infants. Group C ( n = 20 ) were premature newborns with unconjugated hyperbilirubinemia. Group D ( n = 20) were premature control group. We detected their serum levels of S-100, total bilirubin (TBC), albumin and calculated B/A ratio. Results The S-100 level and B/A ratio of hyperbilirubinemia group were significantly higher than those of control group in term infants [group A(0. 36±0. 14)μg/L vs group B (0. 25±0. 07)μg/L,P＜0.05)and premature newborns (group C(0.40±0.09) μg/L vs group D(0.28±0.05)μg/L,P ＜0.05) ].There was positive correlation between level of serum S-100 and B/A ratio in hyperbilirubinemia group of terminfants (r =0. 509,P＜0. 05). Conclusion Serum S-100 protein and B/A ratio may be a sensitive indicators for early predicting bilirubinic toxicity.