胆红素/白蛋白（B/A）比值与早产儿未结合胆红素水平相关。
Bilirubin/albumin (B/A) ratios correlate with unbound bilirubin levels in preterm infants.
机构信息
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
出版信息
Pediatr Res. 2021 May;89(6):1427-1431. doi: 10.1038/s41390-020-01351-z. Epub 2021 Jan 19.
BACKGROUND
A strong correlation between the bilirubin/albumin (B/A) ratio and unbound bilirubin (UB) levels in newborns ≥35 weeks of gestation has been reported. However, in preterm infants, the usefulness of B/A ratios remains unclear.
METHODS
We obtained serum from 381 newborns <35 weeks of gestation. UB levels were measured using the glucose oxidase-peroxidase method. Total serum bilirubin (TB) and albumin (Alb) concentrations were measured spectrophotometrically. Samples were then stratified into two groups based on the infant's phototherapy use. B/A ratios were calculated and correlated with UB levels. Samples taken from infants prior to or never receiving phototherapy (No PTx) were then stratified by gestational age (GA) epochs: 22-27, 28-29, 30-31, and 32-34 weeks and B/A ratios correlated with UB levels.
RESULTS
B/A ratios significantly correlated with UB levels in samples from the No PTx cohort (n = 1250; y = 1.83x - 0.15, r = 0.93) when compared with samples from infants post-phototherapy (Post-PTx, n = 2039; y = 1.05x + 0.09, r = 0.69). Even when stratified by GA, the correlation remained.
CONCLUSIONS
In preterm infants <35 weeks of gestation, B/A ratios correlated with UB levels better in infants prior to or never receiving phototherapy than in those infants receiving phototherapy.
IMPACT
The bilirubin/albumin (B/A) ratio significantly correlates with unbound bilirubin (UB) levels in preterm infants <35 weeks of gestation. The B/A ratio can be used as an index of UB levels in preterm infants <35 weeks of gestation. The B/A ratio is useful, especially when UB measurements are not available, for managing hyperbilirubinemia in preterm infants.
背景
已有研究报道，胎龄≥35 周的新生儿胆红素/白蛋白（B/A）比值与未结合胆红素（UB）水平呈强相关。然而，在早产儿中，B/A 比值的作用尚不清楚。
方法
我们收集了 381 名胎龄<35 周的新生儿血清。采用葡萄糖氧化酶-过氧化物酶法测量 UB 水平。采用分光光度法测量总血清胆红素（TB）和白蛋白（Alb）浓度。根据婴儿是否接受光疗将样本分为两组。计算 B/A 比值，并与 UB 水平相关联。从未接受或未接受过光疗（No PTx）的婴儿的样本，根据胎龄（GA）时期进一步分层：22-27 周、28-29 周、30-31 周和 32-34 周，并与 UB 水平进行 B/A 比值相关分析。
结果
与接受光疗后的样本（Post-PTx，n=2039；y=1.05x+0.09，r=0.69）相比，No PTx 组（n=1250；y=1.83x-0.15，r=0.93）的 B/A 比值与 UB 水平显著相关。即使按 GA 分层，相关性仍然存在。
结论
在胎龄<35 周的早产儿中，与接受光疗的婴儿相比，未接受或从未接受光疗的婴儿的 B/A 比值与 UB 水平相关性更好。
意义
在胎龄<35 周的早产儿中，B/A 比值与 UB 水平显著相关。B/A 比值可作为胎龄<35 周早产儿 UB 水平的指标。B/A 比值在管理早产儿高胆红素血症方面很有用，尤其是在无法测量 UB 时。
Zotero 插件