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触珠蛋白能否作为新生儿黄疸早期诊断的指标?

Can haptoglobin be an indicator for the early diagnosis of neonatal jaundice?

作者信息

Cakmak Alpay, Calik Mustafa, Atas Ali, Hirfanoglu Ibrahim, Erel Ozcan

机构信息

Department of Paediatrics, Harran University School of Medicine, Sanliurfa, Turkey.

出版信息

J Clin Lab Anal. 2008;22(6):409-14. doi: 10.1002/jcla.20279.

Abstract

Neonatal jaundice is the result of an imbalance between bilirubin production and elimination. Bilirubin conjugation in newborns is significantly impaired in the first few days; even a small increase in the rate of production can contribute to the development of hyperbilirubinemia. Hemolysis has a significant role in bilirubin increase in newborns. Intrauterine is tolerated by the maternal metabolism in life. When hemolysis takes place, a decrease is accepted in the haptoglobin and hemopoexin blood levels binding hemoglobin in the environment. Therefore, it may be considered that haptoglobin and hemopoexin from the early period umbilical cord (UC) blood in newborns may be an indicator in determining jaundice likely to develop in later stages. Babies were called to the control polyclinic in the third and fifth days. Eighty-four babies with normal term birth were included in the study. Gestational age of the mothers was 39.5+/-1.5 weeks in average. A significant negative correlation was found between the haptoglobin level from the UC taken during delivery and the bilirubin value in the fifth day (r=-0.345; P=0.001). The haptoglobin value from the blood of the UC can be used as a guiding indicator to demonstrate the future occurrence of jaundice in newborns. This way, the babies with high jaundice risk may be detected earlier and closer follow-up of these babies can be obtained. As a result, the haptoglobin level of the blood from the UC during delivery allows us to make an early prediction on whether neonatal jaundice will occur.

摘要

新生儿黄疸是胆红素生成与排泄失衡的结果。新生儿胆红素结合在最初几天会显著受损;即使生成速率稍有增加也可能导致高胆红素血症的发生。溶血在新生儿胆红素升高过程中起重要作用。在宫内时,溶血由母体代谢耐受。当发生溶血时,环境中结合血红蛋白的触珠蛋白和血红素结合蛋白的血液水平会下降。因此,可以认为新生儿早期脐带血中的触珠蛋白和血红素结合蛋白可能是确定后期可能发生黄疸的一个指标。婴儿在第三天和第五天被召唤到控制门诊。研究纳入了84名足月正常出生的婴儿。母亲的平均孕周为39.5±1.5周。分娩时采集的脐带血触珠蛋白水平与第五天的胆红素值之间存在显著负相关(r = -0.345;P = 0.001)。脐带血中的触珠蛋白值可作为一个指导指标,以证明新生儿未来黄疸的发生情况。通过这种方式,可以更早地检测出黄疸风险高的婴儿,并对这些婴儿进行更密切的随访。因此,分娩时脐带血中的触珠蛋白水平使我们能够对新生儿黄疸是否会发生做出早期预测。

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Managing the assessment of neonatal jaundice: importance of timing.
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