国际医药卫生导报2025，Vol.31Issue(9)：1506-1510,5.DOI:10.3760/cma.j.cn441417-20241125-09019
新生儿ABO溶血病中血清总胆红素、脐血胆红素水平及网织红细胞计数对神经系统损害的预测价值
Predictive value of total bilirubin,umbilical cord bilirubin level,and reticulocyte count in neonatal ABO hemolytic disease to neurological damage
摘要
Abstract
Objective To investigate the abnormal expression of serum total bilirubin(TBil)level,umbilical cord bilirubin level,and reticulocyte(RET)count in neonatal ABO hemolytic disease and their predictive value for neurological damage.Methods A total of 87 neonates with ABO hemolytic disease admitted to Ankang Central Hospital from May 2021 to May 2024 were selected as the study subjects.At the seventh day after birth,the neonates were divided into neurological damage group(35 cases)and neurological non-damage group(52 cases)according to the neonatal behavioral neurological assessment(NBNA)score.There were 20 boys and 15 girls in the neurological damage group,gestational aged(38.53±0.36)weeks.There were 28 boys and 24 girls in the neurological non-damage group,gestational aged(38.49±0.39)weeks.Clinical data of the patients was collected(gestational age,gender,weight,etc.).The serum TBil levels,umbilical cord bilirubin levels,and RET counts were compared between the two groups.Independent sample ttest and x2 test were used for statistical analysis.Multivariate logistic regression analysis was used to analyze the influencing factors of neurological damage in neonates.The receiver operating characteristic curve(ROC)was used to verify the predictive value of serum TBil level,umbilical cord bilirubin level,and RET count for neurological damage in neonates with ABO hemolytic disease,and the area under the curve(AUC)was calculated.Results There were no statistically significant differences in the clinical data between the two groups(all P＞0.05).The serum TBil levels,umbilical cord bilirubin levels,and RET counts of the neurological damage group were higher than those of the non-damage group[(192.53±25.17)μmol/L vs.(169.46±21.42)μmol/L,(47.33±12.06)μmol/L vs.(31.16±8.95)μmol/L,(4.92±1.74)％vs.(3.36±0.98)％](all P＜0.05).Multivariate logistic regression analysis showed that serum TBil level(OR=1.041,95％CI:1.008-1.074,P=0.013),umbilical cord bilirubin level(OR=1.141,95％CI:1.059-1.230,P=0.001)and RET count(OR=2.675,95％CI:1.437-4.977,P=0.002)were independent risk factors for neurological damage in neonates with ABO hemolytic disease(all P＜0.05).ROC results showed that the AUC of the combined prediction of serum TBil level,umbilical cord bilirubin level and RET count for neurological damage in neonates with ABO hemolytic disease was 0.922(95％CI:0.853-0.991),the sensitivity was 91.43％,the specificity was 96.15％,and the Youden index was 0.779.Conclusion Abnormal expression of serum TBil level,umbilical cord bilirubin level,and RET count are closely associated with neurological damage in neonates with ABO hemolytic disease.Combined detection of these indicators holds significant clinical value for predicting neurological damage.关键词
总胆红素/脐血胆红素/网织红细胞计数/ABO溶血病/新生儿/神经系统损害预测Key words
Total bilirubin/Umbilical cord bilirubin/Reticulocyte count/ABO hemolytic disease/Neonates/Prediction of neurological damage引用本文复制引用
张森山,蔡美,孙锋..新生儿ABO溶血病中血清总胆红素、脐血胆红素水平及网织红细胞计数对神经系统损害的预测价值[J].国际医药卫生导报,2025,31(9):1506-1510,5.基金项目
安康市科学技术局项目(AK2021-SFZC-03) Ankang Science and Technology Bureau Project(AK2021-SFZC-03) （AK2021-SFZC-03）
