CAJ | 학술논문

目的：了解新生儿初发高胆红素血症的临床特点。方法回顾性分析2012年6月至2013年5月收治的新生儿初发高胆红素血症的临床资料。结果初发高胆红素血症新生儿共284例，男：女=1.51：1。高胆红素血症病因中，足月儿组ABO溶血、败血症的发生概率高于早产儿组；而早产儿组肺炎、坏死性小肠结肠炎及颅内出血的发生概率高于足月儿组，差异均有统计学意义(P<0.05)。与早产儿比较，足月高胆红素血症新生儿的黄疸出现日龄和黄疸高峰日龄均较早，黄疸持续时间较短，胆红素下降速率较快，黄疸高峰时白蛋白水平较高，黄疸高峰时的间接胆红素水平较高，差异均有统计学意义(P<0.01)。与足月儿非溶血组相比，足月儿溶血组黄疸出现日龄较小，黄疸达高峰的日龄也较小，黄疸高峰时总胆红素水平较高，差异均有统计学意义(P<0.05)。早产儿溶血组经皮胆红素峰值水平高于早产儿非溶血组，差异有统计学意义(P<0.05)。6例胆红素脑病患儿的头颅磁共振成像异常与胆红素峰值水平并不完全一致。结论足月儿与早产儿、溶血性与非溶血性高胆红素血症的临床表现有不同程度的差异。
목적：료해신생인초발고담홍소혈증적림상특점。방법회고성분석2012년6월지2013년5월수치적신생인초발고담홍소혈증적림상자료。결과초발고담홍소혈증신생인공284례，남：녀=1.51：1。고담홍소혈증병인중，족월인조ABO용혈、패혈증적발생개솔고우조산인조；이조산인조폐염、배사성소장결장염급로내출혈적발생개솔고우족월인조，차이균유통계학의의(P<0.05)。여조산인비교，족월고담홍소혈증신생인적황달출현일령화황달고봉일령균교조，황달지속시간교단，담홍소하강속솔교쾌，황달고봉시백단백수평교고，황달고봉시적간접담홍소수평교고，차이균유통계학의의(P<0.01)。여족월인비용혈조상비，족월인용혈조황달출현일령교소，황달체고봉적일령야교소，황달고봉시총담홍소수평교고，차이균유통계학의의(P<0.05)。조산인용혈조경피담홍소봉치수평고우조산인비용혈조，차이유통계학의의(P<0.05)。6례담홍소뇌병환인적두로자공진성상이상여담홍소봉치수평병불완전일치。결론족월인여조산인、용혈성여비용혈성고담홍소혈증적림상표현유불동정도적차이。
Objective To investigate the epidemiological characteristics of incipient neonatal hyperbilirubinemia. Methods The clinical data of admitted neonates with hyperbilirubinemia were retrospectively analyzed from June 2012 to May 2013. Results Two hundred and eight-four neonates with hyperbilirubinemia were enrolled and the ratio of male:female was 1.51:1. For the causes of hyperbilirubinemia, the incidences of ABO hemolytic and sepsis were higher in term infants than those in preterm infants, and the incidences of pneumonia, necrotizing enterocolitis and intracranial hemorrhage were higher in preterm infants than those in term infants (P<0.05). Compared with the preterm infants, the term infants had jaundice appearance and peak at earlier time, shorter duration of jaundice, faster decline rate of jaundice, higher levels of albumin and indirect bilirubin at the peak of jaundice (P<0.01). In the term infants, the time of jaundice appearance and peak were earlier in hemolytic group than those in non-hemolytic group (P<0.05). In preterm infants, the peak of transcutaneous bilirubin was higher in hemolytic group than that in non-hemolytic group (P<0.05). Six cases with bilirubin encephalopathy had abnormalities cranial MRI imaging, and the MRI was not entirely consistent with the peak level of bilirubin. Conclusions There are clinical differences between hemolytic and non-hemolytic hyperbilirubinemia in both term and preterm infants.