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目的通过对高胆红素血症新生儿血清激活素A(ACT A)水平的检测,探讨血清ACT A在新生儿胆红素脑损伤的关系和临床意义。方法应用ELISA方法检测61例足月高胆红素血症(高胆)新生儿和25例正常新生儿血清中ACT A浓度,同步测定血清总胆红素(total serum bilirubin,TSB),高胆组按血清TSB值221～256μmol/L,257～342μmol/L,>342μmol/L分为轻、中、重度三组;对照组TSB<85μmol/L。结果轻、中、重度高胆患儿血清ACT A浓度值分别是(3.68±0.62)μg/L,(4.32±0.53)μg/L,(5.12±0.71)μg/L,较对照组明显升高(P<0.05);在轻、中、重度高胆患儿间,血清ACT A浓度差异有统计学意义(P<0.05),其值随着胆红素升高而升高;血清ACT A浓度与胆红素呈正相关(r=0.82,P<0.01)。结论内源性ACT A参与新生儿胆红素脑损伤的发病过程,其浓度与患儿血清胆红素的水平有关。
Objective To explore the relationship and clinical significance of serum ACT A level in newborns with bilirubin brain injury by detecting serum ACT A levels in neonates with hyperbilirubinemia. Methods The concentrations of ACT A in serum of 61 full-term newborns with hyperbilirubinemia (hypercholesterolemia) and 25 normal newborns were detected by ELISA. The levels of total serum bilirubin (TSB) Serum TSB values of 221 ~ 256μmol / L, 257 ~ 342μmol / L and> 342μmol / L were divided into mild, moderate and severe TSB groups and control group with TSB <85μmol / L. Results The levels of ACT A in children with mild, moderate and severe biliary hypercholesterolemia were (3.68 ± 0.62) μg / L, (4.32 ± 0.53) μg / L and (5.12 ± 0.71) μg / L, (P <0.05). There was a significant difference of serum ACT A concentration in children with mild, moderate and severe gallbladder (P <0.05), and its value increased with the increase of bilirubin. Serum ACT A concentration And bilirubin were positively correlated (r = 0.82, P <0.01). Conclusion Endogenous ACT A is involved in the pathogenesis of neonatal bilirubin brain injury and its concentration is related to the level of serum bilirubin in children.