中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2012年
5期
331-335
,共5页
中华医学会儿科学分会新生儿学组 中国新生儿胆红素脑病研究协作组
中華醫學會兒科學分會新生兒學組 中國新生兒膽紅素腦病研究協作組
중화의학회인과학분회신생인학조 중국신생인담홍소뇌병연구협작조
核黄疸%高胆红素血症%婴儿,新生
覈黃疸%高膽紅素血癥%嬰兒,新生
핵황달%고담홍소혈증%영인,신생
Kernicterus%Hyperbilirubinemia%Infant,newborn
目的 通过多中心流行病学调查研究我国新生儿胆红素脑病的具体发病情况、相关高危因素及预后.方法 在中华医学会儿科分会新生儿学组成员单位进行回顾性调查,以出院诊断胆红素脑病或核黄疸的患儿为研究对象,记录患儿一般情况、围产期高危因素、伴随疾病、胆红素峰值水平、治疗情况、临床转归等内容.结果 2009年1月至12月,33家医院中的28家共报告348例新生儿胆红素脑病或核黄疸病例,仅5家(15.2％)未收治相关患儿.患儿平均出生体重(3112.4±599.6)g,平均胎龄(38.3±2.3)周,其中足月儿291例(83.6％),34 ～ 36周的晚期早产儿40例(11.5％),34周以下的早产儿11例(3.2％),另有6例(1.7％)胎龄不详.其中男婴250例,占71.8％,女婴98例,占28.2％.平均入院日龄为(7.3±5.4)d,其中在出生7d以内入院的247例(71.0％),14 d以后入院的24例(6.9％).348例入院后测得的胆红素峰值为(478.1±175.8)μmol/L,其中300例(86.2％)伴发其他疾病,常见的包括细菌感染(52.6％)、ABO溶血(29.9％)、围产期窒息(10.1％)等,其中109例(31.3％)伴有两种或两种以上疾病.住院期间131例(37.6％)患儿接受了换血治疗,白蛋白和静脉用丙种球蛋白的应用也很常见.随访223例(64.1％),失访125例失访率为35.9％,住院和随访期间共死亡36例,占随访患儿的16.1％.病死组除住院时间明显短于存活组(P＜0.05)外,其他资料差异无统计学意义(P＞0.05).少数民族患儿以回族和壮族为主,G6PD缺乏症所占比例显著高于汉族患儿(P＜0.05),其余临床特点和汉族患儿无异.结论 新生儿胆红素脑病在我国并不少见.制定符合我国国情的高胆红素血症干预指南,及早识别并干预高胆红素血症及其高危因素具有十分重要的意义.
目的 通過多中心流行病學調查研究我國新生兒膽紅素腦病的具體髮病情況、相關高危因素及預後.方法 在中華醫學會兒科分會新生兒學組成員單位進行迴顧性調查,以齣院診斷膽紅素腦病或覈黃疸的患兒為研究對象,記錄患兒一般情況、圍產期高危因素、伴隨疾病、膽紅素峰值水平、治療情況、臨床轉歸等內容.結果 2009年1月至12月,33傢醫院中的28傢共報告348例新生兒膽紅素腦病或覈黃疸病例,僅5傢(15.2％)未收治相關患兒.患兒平均齣生體重(3112.4±599.6)g,平均胎齡(38.3±2.3)週,其中足月兒291例(83.6％),34 ～ 36週的晚期早產兒40例(11.5％),34週以下的早產兒11例(3.2％),另有6例(1.7％)胎齡不詳.其中男嬰250例,佔71.8％,女嬰98例,佔28.2％.平均入院日齡為(7.3±5.4)d,其中在齣生7d以內入院的247例(71.0％),14 d以後入院的24例(6.9％).348例入院後測得的膽紅素峰值為(478.1±175.8)μmol/L,其中300例(86.2％)伴髮其他疾病,常見的包括細菌感染(52.6％)、ABO溶血(29.9％)、圍產期窒息(10.1％)等,其中109例(31.3％)伴有兩種或兩種以上疾病.住院期間131例(37.6％)患兒接受瞭換血治療,白蛋白和靜脈用丙種毬蛋白的應用也很常見.隨訪223例(64.1％),失訪125例失訪率為35.9％,住院和隨訪期間共死亡36例,佔隨訪患兒的16.1％.病死組除住院時間明顯短于存活組(P＜0.05)外,其他資料差異無統計學意義(P＞0.05).少數民族患兒以迴族和壯族為主,G6PD缺乏癥所佔比例顯著高于漢族患兒(P＜0.05),其餘臨床特點和漢族患兒無異.結論 新生兒膽紅素腦病在我國併不少見.製定符閤我國國情的高膽紅素血癥榦預指南,及早識彆併榦預高膽紅素血癥及其高危因素具有十分重要的意義.
목적 통과다중심류행병학조사연구아국신생인담홍소뇌병적구체발병정황、상관고위인소급예후.방법 재중화의학회인과분회신생인학조성원단위진행회고성조사,이출원진단담홍소뇌병혹핵황달적환인위연구대상,기록환인일반정황、위산기고위인소、반수질병、담홍소봉치수평、치료정황、림상전귀등내용.결과 2009년1월지12월,33가의원중적28가공보고348례신생인담홍소뇌병혹핵황달병례,부5가(15.2％)미수치상관환인.환인평균출생체중(3112.4±599.6)g,평균태령(38.3±2.3)주,기중족월인291례(83.6％),34 ～ 36주적만기조산인40례(11.5％),34주이하적조산인11례(3.2％),령유6례(1.7％)태령불상.기중남영250례,점71.8％,녀영98례,점28.2％.평균입원일령위(7.3±5.4)d,기중재출생7d이내입원적247례(71.0％),14 d이후입원적24례(6.9％).348례입원후측득적담홍소봉치위(478.1±175.8)μmol/L,기중300례(86.2％)반발기타질병,상견적포괄세균감염(52.6％)、ABO용혈(29.9％)、위산기질식(10.1％)등,기중109례(31.3％)반유량충혹량충이상질병.주원기간131례(37.6％)환인접수료환혈치료,백단백화정맥용병충구단백적응용야흔상견.수방223례(64.1％),실방125례실방솔위35.9％,주원화수방기간공사망36례,점수방환인적16.1％.병사조제주원시간명현단우존활조(P＜0.05)외,기타자료차이무통계학의의(P＞0.05).소수민족환인이회족화장족위주,G6PD결핍증소점비례현저고우한족환인(P＜0.05),기여림상특점화한족환인무이.결론 신생인담홍소뇌병재아국병불소견.제정부합아국국정적고담홍소혈증간예지남,급조식별병간예고담홍소혈증급기고위인소구유십분중요적의의.
Objective Bilirubin encephalopathy continued to be reported worldwide. This multicenter study was conducted to explore the clinical characteristics,comorbidities and prognosis of bilirubin encephalopathy in China.Methods The survey was conducted in 33 level Ⅲ hospitals.Clinical charts of infants with diagnosis of bilirubin encephalopathy or kernicterus at discharge were reviewed.The data were collected by a detaild questionnaire and analyzed.Results From January to December in 2009,348 cases of bilirubin encephalopathy were reported from 28 hospitals.The mean birth weight was (3112.4± 599.6 ) grams,mean gestational age was ( 38.3 ± 2.3 ) weeks; 291 ( 83.6％ ) cases were term infants,40 ( 11.5％ ) cases were late-preterm infants,and 11 ( 3.2％ ) cases were early preterm infants.After admission,the highest bilirubin level was (478.1 ± 175.8) μmol/L Of all the 348 cases,the age at admission was (7.3 ±5.4) days; 247 (71.0％) cases were admitted before 7 days of age,24 (6.9％) cases were admitted after 14 days of age. Most of the cases (86.2％) were complicated with other conditions,including bacterial infection (52.6％ ),ABO incompatibility (29.9％),and perinatal asphyxia (10.1％ ). A total of 131 infants (37.6％) underwent an exchange transfusion. Use of albumin,intravenous immunoglobulin was also common (68.7％ and 44.0％ respectively).A total of 52 cases were of minority ethnic groups,with significantly higher rate of G6PD deficiency than Han ethnicity cases.During the hospitalization and follow up,36 infants died,and 125 infants ( 35.9％ ) were lost to follow up.Conclusions Bilirubin encephalopathy is still not rare in China,the establishment of a population-based reporting system and prevention of kernicterus remain a high priority among public health institutions.
