Vert P
Service de médecine et réanimation néonatales-génétique, maternité régionale A-Pinard, Nancy, France.
Arch Pediatr. 1998 Sep;5(9):1028-30.
The most important steps of bilirubin metabolism involved in the pathophysiology of neonatal hyperbilirubinemia are: 1) hemoglobin degradation by heme oxygenase; 2) bilirubin binding to serum albumin; 3) bilirubin conjugation to acid glucoronic by glucoronyl transferase. Progress in the knowledge of these metabolic steps allows to understanding of why massive hemolysis, infections, hypoxia and prematurity increase the risk of kernicterus and therefore justify adapted preventive and therapeutic measures.
1）血红素加氧酶降解血红蛋白；2）胆红素与血清白蛋白结合；3）胆红素通过葡糖醛酸基转移酶与酸性葡糖醛酸结合。对这些代谢步骤认识的进展有助于理解为何大量溶血、感染、缺氧和早产会增加核黄疸风险，从而证明采取适当的预防和治疗措施是合理的。
