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目的通过分析新生儿总胆红素(TBIL)与血清肝、肾功能指标及心肌酶谱的关系,探讨新生儿TBIL水平对肝、肾功能及心肌损伤的影响。方法回顾性研究设计。2013年8月至2014年11月期间,收集我院产科出生的1 303例新生儿作为研究对象,并测定新生儿的TBIL、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、白蛋白(ALB)、尿素(BUN)、尿酸(UA)、血肌酐(Cr)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、α-羟丁酸脱氢酶(HBDH)水平。按照新生儿TBIL水平,将研究对象分为3组:正常组(n=606)、轻度黄疸组(n=428)以及中重度黄疸组(n=269),并比较组间肝、肾功能指标及心肌酶谱的差异。结果组间ALT、AST、BUN和UA的测量值差异均没有统计学意义(F=0.58,P=0.56;F=0.73,P=0.33;F=2.00,P=0.14;F=0.23,P=0.80),而组间ALP、GGT、ALB、Cr、CK、HBDH和LDH的测量值差异均有统计学意义(F=3.88,P=0.02;F=10.03,P<0.01;F=15.20,P<0.01;F=4.94,P<0.01;F=5.84,P<0.01;F=14.67,P<0.01;F=12.98,P<0.01)。中重度黄疸组患儿的ALP、GGT、ALB测量值高于正常组的值(P<0.05),中重度及轻度黄疸组患儿的HBDH和LDH测量值均高于正常组新生儿的值(P<0.05),中重度黄疸组患儿的GGT、HBDH和LDH测量值高于轻度黄疸组患儿的值(P<0.05);而中重度及轻度黄疸组患儿的Cr、CK测量值均低于正常组的值(P<0.05)。结论新生儿高胆红素血症对肝、肾功能有一定影响,对心肌能够造成一定损伤;在临床上对黄疸新生儿应及时尽早采取干预和治疗措施,以降低高胆红素血症血症对肝、肾及心肌损伤的风险。
OBJECTIVE: To investigate the effect of TBIL on the liver and renal function and myocardial injury in neonates by analyzing the relationship between neonatal total bilirubin (TBIL) and serum liver and kidney function indexes and myocardial enzymes. Methods Retrospective study design. Between August 2013 and November 2014, 1,330 newborns born in obstetrics and gynecology department of our hospital were collected for the study. The levels of TBIL, ALT, AST, ALP, GGT, ALB, BUN, UA, Cr, LDH, CK, , Alpha-hydroxybutyrate dehydrogenase (HBDH) levels. According to the level of neonatal TBIL, the subjects were divided into three groups: normal group (n = 606), mild jaundice group (n = 428) and moderate and severe jaundice group (n = 269) Differences in indices and myocardial enzymes. Results There were no significant differences in the measured values of ALT, AST, BUN and UA between groups (F = 0.58, P = 0.56; F = 0.73, P = 0.33; 0.80), while there were significant differences in the measurement values of ALP, GGT, ALB, Cr, CK, HBDH and LDH among the groups (F = 3.88, P = 0.02; F = 10.03, P <0.01; F = 15.20, P <0.01; F = 4.94, P <0.01; F = 5.84, P <0.01; F = 14.67, P <0.01; F = 12.98, P <0.01). The levels of ALP, GGT and ALB in the moderate-severe jaundice group were higher than those in the normal group (P <0.05), while the HBDH and LDH in the moderate-severe jaundice group were higher than those in the normal group (P <0.05). The levels of GGT, HBDH and LDH in children with moderate-severe jaundice were higher than those in mild jaundice (P <0.05), while the levels of Cr and CK in children with moderate-severe jaundice The measured values were lower than the normal group (P <0.05). Conclusion Neonatal hyperbilirubinemia has a certain effect on liver and kidney function, which can cause certain damage to the myocardium. In the clinical period, newborns with jaundice should take intervention and treatment as soon as possible to reduce hyperbilirubinemia Disease risk of liver, kidney and myocardial damage.