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目的探讨高间接胆红素血症新生儿S100B蛋白的水平及意义。方法选择高间接胆红素血症新生儿86例,根据有无高危因素(溶血、感染、低蛋白及小日龄等)分为有高危因素组42例、无高危因素组44例,另选无黄疸症状的新生儿30例作为对照组。各组在入院时检测血清S100B蛋白、血清及脑脊液胆红素水平,同时进行听力筛查和新生儿行为能力测定(NBNA评分)。结果高危因素组血清及脑脊液胆红素、血清S100B、听力筛查异常率均高于无高危因素组、对照组(P<0.05或<0.01),NBNA评分低于无高危因素组、对照组(P均<0.05)。高危因素组血清与脑脊液胆红素水平呈正相关(r=0.63,P<0.05),无高危因素组血清与脑脊液胆红素水平无相关性(r=0.13,P>0.05)。高危因素组脑脊液胆红素水平与血清S100B、NBNA评分均呈负相关(r分别为-0.55、-0.58,P均<0.05),无高危因素组脑脊液胆红素水平与血清S100B、NBNA评分无相关性(r分别为0.05、0.08,P均>0.05)。结论有高危因素的高间接胆红素血症新生儿可引起神经系统损伤,应早期干预治疗。
Objective To investigate the level and significance of S100B protein in neonates with high indirect hyperbilirubinemia. Methods Eighty-six neonates with high indirect hyperbilirubinemia were divided into high risk group (n = 42) and non-risk group (n = 44) according to the presence of risk factors (hemolysis, infection, low protein, Thirty newborns without jaundice symptoms served as control group. Serum levels of S100B protein, serum and cerebrospinal fluid (CSF) bilirubin were measured at admission, and hearing screening and neonatal behavioral assessment (NBNA score) were performed simultaneously. Results Serum and cerebrospinal fluid bilirubin, serum S100B and hearing screening abnormalities in risk factors were higher than those without risk factors, control group (P <0.05 or <0.01), NBNA score was lower than those without risk factors, control group P <0.05). There was a positive correlation between serum bilirubin level and cerebrospinal fluid bilirubin level in risk factors group (r = 0.63, P <0.05). There was no correlation between serum bilirubin levels and cerebrospinal fluid bilirubin level in risk factors group (r = 0.13, P> 0.05). Serum levels of CSF bilirubin were negatively correlated with serum S100B and NBNA scores (r = -0.55, -0.58, P <0.05, respectively) in the high-risk group. Serum levels of bilirubin and S100B, Correlation (r = 0.05,0.08, P> 0.05). Conclusion Neonates with high risk of indirect hyperbilirubinemia may cause nervous system damage and should be treated early.