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冈达尔大学综合专科医院光疗前后高胆红素血症新生儿的血液学异常及相关因素。

Hematological abnormality and associated factors in newborns with hyperbilirubinemia before and after phototherapy at University of Gondar Comprehensive Specialized Hospital.

机构信息

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.

Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Sci Rep. 2024 Aug 6;14(1):18210. doi: 10.1038/s41598-024-68871-0.

Abstract

This study aimed to assess the magnitude of hematological toxicity and associated factors in newborns with hyperbilirubinemia. A cross-sectional study was conducted from April to December 2023. A total of 247 newborns were included. The data were collected using questionnaires and a data extraction sheet. Four 4 ml of blood was collected. A Sysmex KX-21 analyzer was used for blood analysis, and a Mindray BS-240 analyzer was used for bilirubin measurement. The data were entered into Epi-data and analyzed by SPSS. The logistic regression was used. The P value was set at 0.05. Before phototherapy, the hematological toxicities, such as anemia, leucopenia, and thrombocytopenia, were 45.7%, 22.2%, and 6.1%, respectively, whereas after phototherapy, anemia and thrombocytopenia, significantly increased, but the leucopenia, significantly decreased. The risk of developing anemia increased, 3.5, 2.7, and 2.1-fold among newborns with bilirubin > 18 mg/dl, with Rh blood group incompatibility, and treated with intensive phototherapy, respectively. Both low birth weight and intensive phototherapy increased the incidence of thrombocytopenia by 2 and 3.4-fold, respectively. Hematological toxicity was found to be a severe public health issue in newborns. Thus, strict follow-up and early detection of toxicity by considering aggravation factors are necessary.

摘要

本研究旨在评估高胆红素血症新生儿血液学毒性的程度及其相关因素。这是一项 2023 年 4 月至 12 月进行的横断面研究。共纳入 247 例新生儿。通过问卷和数据提取表收集数据。采集 4ml 血样,使用 Sysmex KX-21 分析仪进行血液分析,使用 Mindray BS-240 分析仪进行胆红素测量。数据输入 Epi-data 并由 SPSS 进行分析。采用逻辑回归,P 值设为 0.05。光疗前,贫血、白细胞减少和血小板减少等血液学毒性的发生率分别为 45.7%、22.2%和 6.1%,而光疗后,贫血和血小板减少显著增加,白细胞减少显著减少。胆红素>18mg/dl、Rh 血型不合和强化光疗的新生儿贫血风险分别增加 3.5、2.7 和 2.1 倍。低出生体重和强化光疗使血小板减少的发生率分别增加 2 倍和 3.4 倍。血液学毒性是新生儿严重的公共卫生问题。因此,有必要严格随访,并考虑加重因素,早期发现毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a49/11303718/46bb2a4a27b4/41598_2024_68871_Fig1_HTML.jpg

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