摘要
目的探讨不同病因早期新生儿黄疸足跟血胆汁酸谱的变化及其临床意义。方法选取2018年6月至2020年4月在我院产科正常分娩的新生儿250例,出生72 h用干血纸片法采集足跟血样标本备检。根据小时龄胆红素值将纳入新生儿分为溶血性组(20例)和观察组(118例),再按照病因将观察组分为生理性组(50例),母乳性组(42例)和感染组(26例)。采用超高效液相色谱-串联质谱法(UPLC-MS/MS)对备检标本的15种胆汁酸亚组分进行定量分析。结果各组血标本中15种胆汁酸亚组分均有表达,其中胆酸(CA)、鹅脱氧胆酸(CDCA)、熊脱氧胆酸(UDCA)、甘氨石胆酸(GLCA)和牛磺石胆酸(TLCA)水平在各组间均存在显著差异(P<0.05)。结论不同病因的新生儿黄疸早期胆汁酸代谢谱呈现出不同的变化趋势和特征,有助于新生儿可能发展为高胆红素血症的风险预测及其相关病因的分析。
Objective To investigate the changes and clinical significance of heel blood bile acid spectrum in early neonatal jaundice with different etiology.Methods From June 2018 to April 2020,250 newborns with normal delivery in the obstetrics department of our hospital were selected.At 72 h after birth,heel blood samples were collected by dry blood paper method for examination.The newborns were divided into hemolytic group(20 cases)and observation group(118 cases)according to the bilirubin value of hour age,and then the observation group were divided into physiological group(50 cases),breast milk group(42 cases)and infection group(26 cases)according to the etiology.Fifteen bile acids subfractions in the specimen for examination were quantitatively analyzed by ultra performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS).Results Fifteen bile acid subfractions were expressed in the blood samples of each group,among which cholic acid(CA),chenodeoxycholic acid(CDCA),ursodeoxycholic acid(UDCA),glycolithocholic acid(GLCA)and taurolithocholic acid(TLCA)levels were significantly different among the groups(P<0.05).Conclusion The metabolic spectrum of bile acids at the early stage of neonatal jaundice showed different trends and characteristics with different etiology,which would be helpful for the prediction of the risk of neonatal hyperbilirubinemia and the analysis of related etiology.
作者
杨善浦
沈仁
刘红艳
许敏
董虹
项拉丽
李素琴
YANG Shanpu;SHEN Ren;LIU Hongyan;XU Min;DONG Hong;XIANG Lali;LI Suqin(Pediatrics Department,the Yuhuan Branch of the First Affiliated Hospital with Wenzhou Medical University/the People's Hospital of Yuhuan,Yuhuan 317600,China;Obstetrics Department,the Yuhuan Branch of the First Affiliated Hospital with Wenzhou Medical University/the People's Hospital of Yuhuan,Yuhuan 317600,China;Medical Laboratory Department,the Yuhuan Branch of the First Affiliated Hospital with Wenzhou Medical University/the People's Hospital of Yuhuan,Yuhuan 317600,China)
出处
《临床医学研究与实践》
2021年第4期51-53,59,共4页
Clinical Research and Practice
基金
2018年浙江省医药卫生科技计划项目(No.2018KY921)。
关键词
足跟血
胆汁酸谱
新生儿
高胆红素血症
黄疸
heel blood
bile acid spectrum
neonate
hyperbilirubinemia
jaundice
