Bilirubin/Albumin Ratio For Predicting Bilirubin Neurotoxicity

Objective：To explore the value of bilirubin/albumin ratio(B/A) forpredicting bilirubin neurotoxicity.Method：111cases suspected bilirubin encephalopathy in our hospitalfrom Dec2011to Dec2013were divided into normal BAEP group andabnormal BAEP group according to the result of BAEP.The TSB valve andB/A of the two groups were compared respectively.On the basis of TSBvalve,we divided the111cases into three groups and on the basis of B/Aratio,we divided the111cases into three groups.The abnormalities ofBAEP were compared respectively.Results：1.76cases were assigned to normal BAEP group and35cases were inabnormal group.Hour of age,gestational age,birth weight of normal groupwas177.84±141.86h,275.72±8.08d,3339.41±409.85g,respectively.Hour ofage,gestational age,birth weight of abnormal group was178.60114.78h,273.697.30d,3320.86390.74g,respectively.There wasn’tsignificant difference in hour of age, gestational age,birth weight,gender,the way of delivery between normal BAEP group and abnormalgroup(P>0.05).2.The causes of hyperbilirubinemia included infection factor of58cases,hemolysis factor of45cases(ABO hemolytic disease of40cases,Rhhemolytic disease of5cases),8cases for unknown reasons.3.TSB valve of normal BAEP group was418.7896.89μmol/L and451.72135.07μmol/L in abnormal group.B/A of normal BAEP group was6.32±1.43（mg/g） and7.23±2.39（mg/g） in abnormal group.Thedifference of TSB valve between the two groups wasn’t significant(t=-1.297，P>0.05),but the difference of B/A was significant(t=-2.079，P<0.05).4.The abnormalities of BAEP at different levels of TSB value didn’thave significant difference(χ2=0.157，P>0.05).The abnormalities of BAEPat different levels of B/Ahad significant difference(χ2=12.060，P<0.05).5.The abnormal rate of NBNA score of the111cases was22.5%.Theabnormal rate in normal BAEP group was19.7%.However,it was28.6%inabnormal group.There wasn’t significantly different in abnormal rate ofNBNAscore between normal BAEP group and abnormal group(χ2=1.072，P>0.05).Conclusion：1.We can’t just depend on TSB value to predict bilirubinneurotoxicity.We suggest that B/A should be used as one of the indices of predicting bilirubin neurotoxicity.2.Many factors can affect the bilirubin neurotoxicity.We can’t onlydepend on TSB value or B/A to evaluate the prognosis.The condition ofblood brain barrier and risk factors should be considered at the same time.3.Correct assessment and timely treatment are very important for thedevelopment and prognosis of hyperbilirubinemia.