摘要
目的探讨高胆红素血症(HB)对新生儿神经行为及智能发育的影响。方法选取轻中度非结合性HB新生儿57例为治疗组,同期正常足月新生儿53例为对照组。观察2组干预前、干预后1 d及出生后7、14 d时血清总胆红素(TSB)水平及神经行为的变化,比较出生后6、12个月智能发育情况,并分析新生儿神经行为测定(NBNA)评分与TSB水平的相关性。结果干预前及干预后1 d,出生后7、14 d,治疗组TSB水平显著高于对照组(P<0.05或P<0.01),而NBNA评分显著低于对照组(P<0.01);治疗组出生后14 d NBNA评分恢复至正常范围,但仍低于对照组(P<0.01)。出生后6个月,治疗组智能发育指数(MDI)及运动发育指数(PDI)均显著低于对照组(P<0.01);出生后12个月,2组MDI及PDI无显著差异(P>0.05)。TSB水平与NBNA评分呈显著负相关(r=-0.969,P=0.031)。结论 HB对新生儿神经行为及智能发育均有一定影响,及早进行干预能有效逆转胆红素对中枢神经系统的损伤,加速神经行为恢复。
Objective To explore the influence of hyperbilirubinemia（ HB） on neonatal nerve behavior and intellectual development. Methods A total of 57 neonates with mid-to-moderate non-associative HB were selected as treatment group,while 53 normal full-term neonates in the same period were selected as control group. The changes of total serum bilirubin（ TSB） level and nerve behavior were observed before intervention,1 day after intervention and 7,14 days after birth in both groups. The intellectual development was compared at the time points of 6,12 months after birth between two groups. Correlation between neonatal behavioral neurological assessment（ NBNA） score and TSB level was analyzed. Results The TSB level of the treatment group was significantly higher than that of the control group at the time points of before intervention,1 day after intervention and 7,14 days after birth（ P〈0. 05 or P〈0. 01）,while the NBNA score was significantly lower than that in the control group（ P〈0. 01）. After intervention,the NBNA score of treatment group returned to the normal range 14 days after birth,but it was still lower than the control group（ P〈0. 01）. Six months after birth,the mental development index（ MDI） and psychomotor development index（ PDI） of the observation group were significantly lower than those of the control group（ P〈0. 01）,but there were no significant differences of the MDI and PDI 12 months after birth between two groups（ P〈0. 05）. TSB level was negatively correlated with the NBNA score（ r =- 0. 969,P = 0. 031）. Conclusion HB shows certain impacts on neonatal nerve behavior and intellectual development. Early intervention can effectively reverse the damage of bilirubin to the central nervous system and accelerate the recovery of nerve behavior.
出处
《实用临床医药杂志》
CAS
2016年第3期88-90,94,共4页
Journal of Clinical Medicine in Practice
关键词
高胆红素血症
神经行为
智能发育
新生儿
hyperbilirubinemia
nerve behavior
intellectual development
neonates
