葡萄糖-6-磷酸脱氢酶缺乏症婴儿中溶血与黄疸之间的相关性较差。

Poor correlation between hemolysis and jaundice in glucose 6-phosphate dehydrogenase-deficient babies.

作者信息

Jalloh Salamatu, Van Rostenberghe Hans, Yusoff Narazah M, Ghazali Selamah, Nik Ismail Nik Zainal, Matsuo Masafumi, Wahab Nor Akmal, Nishio Hisahide

机构信息

Department of Pediatrics, Universiti Sains Malaysia, Kelantan, Malaysia.

出版信息

Pediatr Int. 2005 Jun;47(3):258-61. doi: 10.1111/j.1442-200x.2005.02052.x.

DOI:10.1111/j.1442-200x.2005.02052.x

PMID:15910447

Abstract

BACKGROUND

The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ.

METHODS

Four groups of babies were included in the study: (i) G6PD deficient with NNJ; (ii) G6PD deficient without NNJ; (iii) G6PD normal with NNJ; and (iv) normal controls. Babies with other known causes of jaundice were excluded from the study. All subjects underwent the following investigations on day 3-5 after birth: hemoglobin level (Hb), serum bilirubin level, carboxyhemoglobin (CO-Hb) concentration, reticulocyte count and full blood picture. The results of the investigations were compared between the groups using SPSS version 11.

RESULTS

Babies with G6PD and jaundice had a similar percentage of CO-Hb to babies with G6PD without NNJ or babies with normal G6PD and NNJ (1.76 +/- 0.40% vs 1.66 +/- 0.31% and 1.67 +/- 0.28%, respectively; P: 0.23 and 0.41, respectively). Total Hb levels and reticulocyte counts were not significantly different between the groups. The blood film showed more (even though not reaching significance) hemolysis in the G6PD patients but results of the blood film were very similar for G6PD patients with and those without NNJ.

CONCLUSION

Hemolysis is not a main determinant of neonatal jaundice in G6PD-deficient babies.

摘要

背景

近期，葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症患者中，溶血在新生儿黄疸（NNJ）病理生理学中的作用受到质疑。本研究旨在确定溶血在患有G6PD缺乏症和NNJ的马来新生儿黄疸病理生理学中的作用。

方法

本研究纳入四组婴儿：（i）患有NNJ的G6PD缺乏症婴儿；（ii）无NNJ的G6PD缺乏症婴儿；（iii）患有NNJ的G6PD正常婴儿；（iv）正常对照组。排除有其他已知黄疸病因的婴儿。所有受试者在出生后第3至5天接受以下检查：血红蛋白水平（Hb）、血清胆红素水平、碳氧血红蛋白（CO-Hb）浓度、网织红细胞计数和全血细胞图像。使用SPSS 11版对各组检查结果进行比较。

结果

患有G6PD和黄疸的婴儿的CO-Hb百分比与无NNJ的G6PD缺乏症婴儿或患有NNJ的G6PD正常婴儿相似（分别为1.76±0.40%、1.66±0.31%和1.67±0.28%；P值分别为0.23和0.41）。各组之间的总Hb水平和网织红细胞计数无显著差异。血涂片显示G6PD缺乏症患者的溶血情况更多（尽管未达到显著水平），但患有和未患有NNJ的G6PD缺乏症患者的血涂片结果非常相似。