The Value Of Serum Unconjugated Bilirubin/albumin Ratio In The Neonatal Bilirubin Encephalopathy Forecast

Objective To investigate value of serum unconjugated bilirubin (UCB) and the unconjugate bilirubin/albumin (UCB/A) ratio in neonatal bilirubin encephalopathy forecast. Methods 128 term newborns admitted in neonatal ward of author's hospital during May 2009 to December 2009 for neonatal jaundice were selected in this study, their levels of total serum bilirubin ( TSB) , unconjugated bilirubin UCB, unconjugate bilirubin/albumin (UCB/A) ratio (UCB/A) were measured and their associated diseases were monitored .The correlation analysis between UCB/A and such factors were performed.35 cases of neonatal bilirubin encephalopathy in this group were diagnosed. The one-way compare between UCB/A and such factors were performed ,which could be valuable in diagnosing bilirubin-induced encephalic damage. Results There were 128 term newborns of hyperbilirubinemia,in which 35 paitients had been combined with bilirubin encephalopathy(31 cases in in warning period,4 cases in convulsion period) and 93 cases were normal. TSB ( 356.23±98.29 )μmol/L,UCB(340.07±94.41)μmol/L,UCB/A(0.61±0.18). The results suggested that a positive correlation existed among TSB and UCB.So did B/A and UCB, UCB/A and TSB, UCB/A and UCB. ALB did not correlate to UCB,but it suggested that a negtive correlation existed among ALBand UCB/A. In this group, there was no significant correlation between TSB in the ones had got bilirubin encephalopathy and the normal. The data analysis displayed that UCB,ALB,B/A and UCB/A were the valuable indicator of bilirubin encephalopathy diagnosis. It was observed the results of bilirubin encephalopathy diagnosis with UCB,B/A ratio and UCB/A ratio as the index separately. The Youden index reached the peak,while UCB reached 387.75μmol/L(22.68mg/dL), B/A ratio reached 0.68,or UCB/A ratio reached 0.71.Conclusion The UCB/A ratio can be used as a sensitive indicator of bilirubin encephalopathy. While UCB/A radio over 0.71, we should pay great attention to the paitients of hyperbilirubinemia and take comprehensive treatments actively.