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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。
Objective To investigate the dynamic changes of serum total bilirubin in neonatal asphyxia and its relationship with brain injury. Methods Fifty-eight neonates with asphyxia (asphyxia group) and 30 healthy term neonates (control group) were enrolled in our hospital from November 2006 to February 2011. The patients in asphyxia group 33 cases of degree of asphyxia and 25 cases of severe asphyxia. The changes of serum total bilirubin level at 1, 3, 5 and 7 days after birth were detected and the relationship between them and asphyxia brain injury was analyzed. Results At 1, 3, 5 and 7 days after birth, the trend of serum TBIL concentrations in three groups was similar. Compared with mild asphyxia group and control group (P <0.05), the level of serum TBIL at each time point in severe asphyxia group was significantly lower than that in mild asphyxia group and the control group (P <0.05) Control group (P <0.05). Serum TBIL concentrations in brain injury group were similar to those in CT normal group. Serum TBIL concentrations in neonatal brain injury group were significantly lower than those in normal control group at 3, 5 and 7 days after birth (P <0.05) . Conclusion Monitoring the dynamic changes of serum bilirubin concentration is very important for predicting the prognosis and guiding treatment of asphyxia.