Cashore W J, Oh W
Pediatrics. 1982 Apr;69(4):481-5.
Unbound bilirubin, bilirubin binding capacity, and bilirubin binding affinity were determined by the horseradish peroxidase method at the time of maximum hyperbilirubinemia and/or before exchange transfusions in 13 preterm infants who later died and had autopsies performed. Five of the 13 infants had kernicterus at autopsy. There were no significant differences in weight, gestational age, highest indirect bilirubin level, albumin concentration, severity of acidosis, use of assisted ventilation, sepsis, or other major clinical complications between the five infants with kernicterus and the eight infants without kernicterus. Compared with the eight nonkernicteric infants, the five kernicteric infants had significantly higher unbound bilirubin concentrations (13 +/- vs 27 +/- 9 nmoles/liter, respectively, P less than .05) and significantly lower bilirubin binding capacity and affinity. The data suggest an association between low bilirubin binding capacity and affinity, increased unbound bilirubin, and kernicterus in preterm infants with severe clinical complications.
采用辣根过氧化物酶法，在13例后来死亡并接受尸检的早产儿出现最大高胆红素血症时和/或进行换血治疗前，测定其游离胆红素、胆红素结合能力和胆红素结合亲和力。13例婴儿中有5例在尸检时患有核黄疸。5例患有核黄疸的婴儿和8例没有核黄疸的婴儿在体重、胎龄、最高间接胆红素水平、白蛋白浓度、酸中毒严重程度、使用辅助通气、败血症或其他主要临床并发症方面没有显著差异。与8例无核黄疸的婴儿相比，5例有核黄疸的婴儿游离胆红素浓度显著更高（分别为13±与27±9纳摩尔/升，P<0.05），胆红素结合能力和亲和力显著更低。数据表明，在患有严重临床并发症的早产儿中，低胆红素结合能力和亲和力、游离胆红素增加与核黄疸之间存在关联。
