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目的:探讨通过检测脑脊液中未结合胆红素(UCB)的水平对诊断高胆红素血症患儿病情的临床价值,为临床上高胆红素血症患儿病情的正确判断和治疗提供依据。方法:将聊城市人民医院新生儿科收治的24例高胆红素血症伴胆红素脑病患儿作为观察组,同期单纯高胆红素血症患儿20例作为对照组。检测两组新生儿的脑脊液UCB水平、血浆UCB与白蛋白比值(B/A)差异;并分析脑脊液中UCB与血浆中UCB、B/A值的相关性及脑脊液中UCB与患儿发生酸中毒的相关性。结果:观察组的血浆UCB、脑脊液UCB、B/A值均明显大于对照组患儿,且差异均具有统计学意义(P<0.05);两组脑脊液中UCB与血浆中UCB水平比较,差异无统计学意义(P>0.05);两组脑脊液中UCB与血浆中B/A值比较,差异有统计学意义(P<0.05);观察组有14例患儿发生轻度酸中毒,10例患儿发生中重度酸中毒,两组脑脊液UCB水平比较,中重度酸中毒患儿的脑脊液中UCB水平显著高于轻度患儿,且差异具有统计学意义(P<0.05)。结论:通过检测脑脊液中未结合UCB的水平能够作为判断高胆红素血症患儿病情的敏感指标,尤其是作为UCB脑病的检测指标。
Objective: To explore the clinical value of detection of unconjugated bilirubin (UCB) in cerebrospinal fluid in the diagnosis of children with hyperbilirubinemia and to provide a correct diagnosis and treatment of the disease in children with hyperbilirubinemia in accordance with. Methods: Twenty-four children with hyperbilirubinemia and bilirubin encephalopathy admitted to neonatology department of Liaocheng People’s Hospital were selected as the observation group and 20 children with hyperbilirubinemia during the same period as the control group. The levels of UCB and the ratio of UCB to albumin (B / A) in cerebrospinal fluid of two groups were detected. The correlation between UCB and plasma UCB and B / A in cerebrospinal fluid and UCB in cerebrospinal fluid Relevance. Results: The UCB and B / A values of UCB and CSF in the observation group were significantly higher than those in the control group (P <0.05). There was no significant difference between UCB and UCB levels in cerebrospinal fluid (P> 0.05). There was significant difference between UCB and B / A in cerebrospinal fluid in two groups (P <0.05). In the observation group, mild acidosis occurred in 14 patients and in 10 patients Children with moderate to severe acidosis, UCB levels in both groups of cerebrospinal fluid in children with moderate to severe acidosis UCB levels were significantly higher than mild children, and the difference was statistically significant (P <0.05). Conclusion: The detection of unbound UCB levels in cerebrospinal fluid can be used as a sensitive index to judge the condition of children with hyperbilirubinemia, especially as a detection index of UCB encephalopathy.