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目的:探讨分析非结合胆红素(DBIL)及血清白蛋白(ALB)在新生儿黄疸诊断及分类中的应用价值。方法:收集衢州市妇幼保健院2011年1月~2013年12月收治入院的137例新生儿黄疸患者,根据不同的严重程度和病因进行分组,检测各组患儿的非结合胆红素(DBIL)、总胆红素(TBIL)、血清白蛋白(ALB)及β2微球蛋白水平。采用受试者工作曲线(ROC)比较DBIL、DBIL/ALB和TBIL/ALB对于核黄疸的诊断水平。结果:重度黄疸的非结合胆红素、总胆红素、非结合胆红素/白蛋白和β2微球蛋白水平均显著高于中度黄疸,P<0.01。有核黄疸的非结合胆红素、总胆红素、非结合胆红素/白蛋白和β2微球蛋白水平均显著高于无核黄疸,P<0.05。感染性黄疸的非结合胆红素、总胆红素、非结合胆红素/白蛋白和β2微球蛋白水平均显著高于溶血性黄疸,P<0.05。DBIL、DBIL/ALB和TBIL/ALB三者的ROC曲线下面积相似。结论:可以通过检测新生儿黄疸患儿的非结合胆红素及血清白蛋白水平,DBIL、DBIL/ALB的比值来协助针对疾病严重程度和病因给予针对性治疗,利于患儿早期康复。
Objective: To investigate the value of non-conjugated bilirubin (DBIL) and serum albumin (ALB) in the diagnosis and classification of neonatal jaundice. Methods: 137 neonates with jaundice admitted to Quzhou Maternal and Child Health Hospital from January 2011 to December 2013 were enrolled in this study. The patients were divided into different groups according to their severity and etiology. The levels of non-conjugated bilirubin (DBIL) ), Total bilirubin (TBIL), serum albumin (ALB) and β2 microglobulin levels. The receiver operating curve (ROC) was used to compare the diagnostic value of DBIL, DBIL / ALB and TBIL / ALB for kernicterus. Results: The levels of unconjugated bilirubin, total bilirubin, unconjugated bilirubin / albumin and β2 microglobulin in severe jaundice were significantly higher than those in moderate jaundice (P <0.01). Unconjugated bilirubin, total bilirubin, unconjugated bilirubin / albumin and β2 microglobulin with kernicterus were significantly higher than those without kernicterus, P <0.05. Infectious jaundice, unconjugated bilirubin, total bilirubin, unconjugated bilirubin / albumin and β2 microglobulin levels were significantly higher than hemolytic jaundice, P <0.05. The areas under the ROC curves of DBIL, DBIL / ALB and TBIL / ALB were similar. Conclusion: The detection of neonatal jaundice in children with unconjugated bilirubin and serum albumin levels, DBIL, DBIL / ALB ratio to help address the severity of the disease and cause of targeted treatment, which will benefit the early recovery of children.