Windorfer A, Karitzky D
Monatsschr Kinderheilkd (1902). 1975 Jan;123(1):27-30.
Bilirubin encephalopathy in the newborn is caused not so much by the level of total serum bilirubin but rather by the level of free bilirubin not bound to albumin. Compared to adults prematures and newborns show a higher tendency towards separation of bilirubin from the albumin bond which is statistically significant as could be demonstrated by measurements in serum and plasma. This might be due to a lower bilirubin binding capacity of the neonatal albumin or a competitive displacement of the bilirubin from the albumin bonds by unknown endogenous substances. The influence of several drugs, of blood exchange transfusion and of light in phototherapy on the cleavage of bilirubin from its albumin bond was examined. Some drugs, but not the phototherapylight, enhanced displacement.
新生儿胆红素脑病的发生并非主要由血清总胆红素水平所致，而是由未与白蛋白结合的游离胆红素水平引起。与成人相比，早产儿和新生儿胆红素与白蛋白结合物分离的倾向更高，血清和血浆检测显示这种差异具有统计学意义。这可能是由于新生儿白蛋白的胆红素结合能力较低，或者是未知内源性物质竞争性取代了胆红素与白蛋白的结合。研究了几种药物、换血疗法及光疗中的光照对胆红素与白蛋白结合物解离的影响。一些药物可增强这种取代作用，但光疗中的光照不会。
