| Objective:To analyze the clinical features of bilirubin encephalopathy(BE) in mature and explore the possible factors that affect the sequelae of patients.Methods:Retrospective analysis on data collected from August 20,2005 to September 30,2009 was performed.The records of 87 matures suffering from BE in Neonatology ward of The First Affiliated Hospital of Guangxi Medical University were analyzed.The clinical features were summarized and the serum total bilirubin, total bilirubin/albunlin(B/A) ratio of them were analyzed. And the results of the neonatal behavioral neurological assessment (NBNA), cranial magnetic resonance imaging (MRI), brain stem auditory evoked potentials (BAEP) and the follow-up visits of some of them were analyzed too.Results:(1)In the 87 full-term newborns with BE, the male was 69 cases and the female was 18 cases.The age that BE happened was (4±3) days.75 cases (86.2%)had BE at age≤7 days. The clinical anifestations including hypertonia of extensor muscles (60.9%), retrocollis or opisthotonos (48.3%), agitation or irritability (47.1%) were more common. There were 21 cases(24.1%) in warning period and 66 cases (75.9%)in spasmodic period. (2) 49 cases (56.3%) had glucose-6-phosphate dehydrogenase (G-6PD) deficiency diseases, 30 cases (34.5%) had ABO hemolytic disease and 23 cases (26.4%) had infectious diseases. (3) The mean TSB in the warning period group was 428.0± 80.1umol/L while the spasmodic period group was 499.3±138.5umol/L.The latter was higher.There was significant statistics difference (t=-2.922, p= 0.005). The mean B/A in the warning period group was 7.0±1.5mg/g while the spasmodic period group was 8.6±2.4mg/g.The latter was higher.There was significant statistics difference (t=-3.416, p=0.001). (4)In the 55 cases with NBNA examinations,28 cases (50.9%) had points<35. There were 5 cases (29.4%) in warning period while 23 cases (60.5%) in spasmodic period with NBNA<35 points. There was significant statistics difference (p<0.05) in the rate that NBNA<35 points happened. In the 19 cases with head MRI examination, no one had abnormal high signal in bilateral globus pallidus.It made differents with the typical changes in domestic and international coverage 17 cases had BAEP examinations. The abnormality rate was 59% and it showed as a variety of forms. (5) In the 43 cases that had a follow-up visit,13 cases had sequelae. Between the group with sequelae to the group without sequelae, there was significant statistics difference(p<0.05) in TSB, but there were no significant statistics difference (p> 0.05) in the B/A ratio, the age that BE occured and the age that the patients were sent to hospital.The extent of BE and the infections made no differences to the incidence of sequelae (p> 0.05).Conclusion:(1) Infants with the age≤7 days are more easier to have BE. (2) G-6PD deficiency diseases and ABO hemolytic diseases are the major factors which causes BE in Guangxi. (3)TSB and B/A ratio makes positive collection with the extent of BE. (4)NBNA and BAEP can be used to evaluate the prognosis of BE. (5)The higher the TSB is, the occurrence of sequelae may be greater.
|
PDF Full Text Request