脐血促红细胞生成素、胆红素水平及网织红细胞计数作为新生儿高胆红素血症早期预测指标的研究
Study of Cord Blood Levels of Erythropoietin, Bilirubin and Reticulocyte Count as Early Predictors of Neonatal Hyperbilirubinemia.
作者信息
Elfarargy Mohamed S, Al-Ashmawy Ghada M, Abu-Risha Sally, Khattab Haidy
机构信息
Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt.
Department of Biochemistry, Faculty of Pharmacy, Tanta University, Egypt.
出版信息
Endocr Metab Immune Disord Drug Targets. 2021;21(9):1641-1648. doi: 10.2174/1871530321666201229152019.
BACKGROUND
Neonatal hyperbilirubinemia is a serious neonatal problem which has hazardous effects on the neonates when the level of indirect bilirubin is increased to the levels that could cause kernicterus.
AIMS
The aim of this research is to study the cord blood levels of erythropoietin (EPO), bilirubin and reticulocyte count (RC) as early predictors of neonatal hyperbilirubinemia.
METHODS
This is a case-control study, which was conducted at Tanta University Hospital (TUH) from July 2016 to March 2018 on 90 neonates. The studied neonates were divided into 2 groups: Group 1 (45 neonates) who developed pathological hyperbilirubinemia and required treatment and group 2(45 neonates) who did not develop pathological hyperbilirubinemia and did not require treatment. Cord blood levels of EPO, bilirubin and RC were measured in all the studied neonates in both groups.
RESULTS
There was a significant difference between both groups with regard to cord blood bilirubin (CBB), hemoglobin, EPO and RC levels where the P. value is 0.001*,0.027, 0.001&0.001respectively. There was a significant positive correlation between cord blood EPO levels and both CBB and cord blood RC with r=0.610 and 0.579, respectively and P. value is 0.001 & 0.001* respectively. With regard to ROC curve, there were high cord blood EPO levels where the cut off value was 22.5 mIU/ml while the sensitivity and specificity were 96 and89, respectively. In the cord blood RC, the cut off value was 5.7% while the sensitivity and specificity were 93 and 85, respectively, and lastly, CBB where the cut off value was 1.8 mg/dl while the sensitivity and specificity were 89 and 78 respectively.
CONCLUSION
Cord blood levels of EPO, bilirubin and RC were increased in cases of pathological neonatal hyperbilirubinemia.
RECOMMENDATION
Cord blood levels of EPO, bilirubin and RC could be used for early prediction of pathological neonatal hyperbilirubinemia.
背景
新生儿高胆红素血症是一个严重的新生儿问题，当间接胆红素水平升高到可导致核黄疸的程度时，会对新生儿产生有害影响。
目的
本研究旨在探讨脐血促红细胞生成素（EPO）、胆红素和网织红细胞计数（RC）水平作为新生儿高胆红素血症的早期预测指标。
方法
这是一项病例对照研究，于2016年7月至2018年3月在坦塔大学医院（TUH）对90例新生儿进行。所研究的新生儿分为两组：第1组（45例新生儿）发生病理性高胆红素血症并需要治疗，第2组（45例新生儿）未发生病理性高胆红素血症且不需要治疗。对两组所有研究新生儿的脐血EPO、胆红素和RC水平进行了测量。
结果
两组在脐血胆红素（CBB）、血红蛋白、EPO和RC水平方面存在显著差异，P值分别为0.001*、0.027、0.001和0.001*。脐血EPO水平与CBB和脐血RC均呈显著正相关，r分别为0.610和0.579，P值分别为0.001和0.001。关于ROC曲线，脐血EPO水平较高，临界值为22.5 mIU/ml，敏感性和特异性分别为96和89。在脐血RC中，临界值为5.7%，敏感性和特异性分别为93和85，最后，CBB的临界值为1.8 mg/dl，敏感性和特异性分别为89和78。
结论
病理性新生儿高胆红素血症病例中脐血EPO、胆红素和RC水平升高。
建议
脐血EPO、胆红素和RC水平可用于病理性新生儿高胆红素血症的早期预测。
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