论文部分内容阅读
目的 探讨新生儿黄疸中碳氧血红蛋白 (COHb)检测的临床价值 ,以及COHb与血总胆红素 (STB)浓度和γ -谷氨酰转肽酶 (γ -GT) 3者之间的相关性 ,来判断新生儿黄疸中胆红素是否产量过多或结合排泄功能障碍。方法 利用血红蛋白在乙酸缓冲溶液中经一定温度和时间作用后 ,氧合血红蛋白沉淀与碳氧血红蛋白分离 ,根据未沉淀碳氧血红蛋白的色泽深浅进行比色定量。结果 ①≤ 7d和 8～ 14d两组之间COHb有显著差异 ,t =9.31,P <0 .0 0 1;8～ 14d和 15～ 2 8d两组之间t=1.2 8,P >0 .0 5 ;②≤ 7dCOHb(3.74± 0 .81)、STB(333.84± 130 .6 3)均明显异常升高 ,而γ -GT有轻度异常 ;③ 8- 14dCOHb(2 .34± 0 .5 1) ,虽有异常 ,但与STB(346 .81± 5 1.6 6 )变化不相平行 ,但STB与γ -GT的变化有一定相关。结论 早期新生儿COHb较晚期新生儿黄疸组有显著差异 ,证实了早期新生儿黄疸主要是以胆红素生成较多 ,伴有轻度肝脏结合排泄功能损害 ;晚期新生儿黄疸的机制是多因素的 ,除了与胆红素生成增多外 ,还与肝细胞摄取、结合、排泄缺陷以及胆红素的肠肝循环增加等有关。
Objective To investigate the clinical value of detecting carboxyhemoglobin (COHb) in neonatal jaundice and the correlation between COHb and total serum bilirubin (STB) and γ - glutamyl transpeptidase (γ - GT) , To determine if bilirubin in the newborn jaundice is overproduced or in combination with excretory dysfunction. Methods Using hemoglobin in acetic acid buffer solution for a certain temperature and time, the hemoglobin precipitate was separated from carboxyhemoglobin, and the color was quantified according to the color of the uncovered carboxyhemoglobin. Results ① There was a significant difference in COHb between the two groups at ≤ 7d and 8 ~ 14d, t = 9.31, P <0.001; t = 1.2 8, P> 0 between 8 and 14 days and between 15 and 28 days. 0 5; ②≤7 dCOHb (3.74 ± 0.81), STB (333.84 ± 130.63) were significantly increased, while γ -GT mild abnormality; ③ 8- 14dCOHb (2.34 ± 0.5 1). Although abnormal, it was not parallel with the change of STB (346.81 ± 5.16.6), but there was a certain correlation between STB and γ-GT. Conclusion The early neonatal COHb neonatal jaundice group were significantly different, confirmed that early neonatal jaundice is mainly bilirubin formation, accompanied by mild liver excretion dysfunction; late neonatal jaundice mechanism is multifactorial , In addition to increased production with bilirubin, but also with the liver cell uptake, binding, excretion defects, and bilirubin increased enteric liver cycle and so on.