摘要
目的：探讨γ-谷氨酰转肽酶（γ-GT）在足月新生儿高未结合胆红素（UCB）神经毒性早期评估中的应用价值。方法选取2013年1月至2015年1月扬州大学临床医学院新生儿科收治的120例高胆红素血症足月新生儿为研究对象（该研究遵循的程序符合该院人体试验委员会所制定的伦理学标准，得到该委员会批准，并征得受试对象监护人的知情同意，与之签署临床研究知情同意书），根据脑干听觉诱发电位（BAEP）结果将其分为A、B、C、D 4组。比较4组患儿血清γ-GT、UCB水平及行为神经测定评分（NBNA），并分析之间相关性。结果不同组间血清γ-GT、 UCB水平及NBNA评分比较，差异均有统计学意义（F=6.341，7.528，5.023 P〈0.01）。轻度脑损害组血清γ-GT 和UCB值虽均高于对照组，NBNA评分低于对照组，但两组UCB值比较，差异无统计学意义（P〉0.05）；而血清γ-GT水平、NBNA评分比较差异均有统计学意义（P〈0.05）。中及重、极重度脑损害组患儿的血清γ-GT和UCB水平均高于对照组；NBNA评分低于对照组（P〈0.01）。不同程度脑损害组间血清γ-GT、 UCB水平及NBNA评分比较，差异均有统计学意义（P〈0.05，0.01）；且脑损害程度越重，血清γ-GT和UCB水平均越高， NBNA评分越低。且ROC曲线下血清γ-GT面积大于UCB面积（P〈0.05）；血清γ-GT 水平与NBNA评分呈负相关（r =-0.5563，P〈0.01）；血清UCB水平与NBNA评分呈较弱负相关（r=-0.2925， P〈0.05）。结论血清γ-GT能及早反映UCB神经毒性损伤，可作为早期评估足月新生儿UCB神经毒性损伤及其程度的一项重要参考指标。
ObjectiveTo investigate the application value of serum γ-glutamyl transpeptidase（γ-GT） in early evaluation for full-term neonates with unconjugated hyperbilirubinemia neurotoxicity.Methods From January 2013 to January 2015,120 full-term neonates with unconjugated hyperbilirubinemia were divided into four groups（A,B,C,D） according to the results of brainstem auditory evoked potential（BAEP）.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Clinic Medical behavioral neurological assessment （NBNA） were compared among four groups,meanwhile the College of Yangzhou University.Informed consent was obtained from each parents. The serum levels of γ-glutamyl transpeptidase,unconjugated bilirubin（UCB）and the score of neonatal correlation for these parameters were assayed.Results There were significant differences in the level ofγ-GT,UCB and the score of NBNA among different groups（F=6.341,7.528,5.023P〈0.01）.The level of serum γ- GT and UCB were higher in mild brain injury group than those in control group when the score of NBNA was lower in mild brain injury group than that in control group ,but there was no statistically significant difference for UCB （P〉 0.05）;while there were significant difference in γ- GT level and score of NBNA between two groups（P〈0.05）.The concentrations of serum γ- GT and UCB in moderate,severe and critical brain damage groups were significantly higher than those in control group （P〈0.01）,while the score of NBNA in these brain damage groups were significantly lower than that in control group （P〈0.01）.There were significant differences for the levels of γ-GT,UCB and the score of NBNA among different degree of brain injury groups（P〈0.05,0.01）.also when the more severe brain injury was,the higher levels of serum γ-GT and UCB were,the lower score of NBNA was.The area under the ROC curve of serum γ- GT was greater than that of serum UCB （P〈0.05）.By linear correlation analysis,level of γ-G
出处
《中国临床实用医学》
2015年第6期20-23,共4页
China Clinical Practical Medicine
