| | | β－葡萄糖醛酸苷酶在母乳性黄疸发病中的作用
| | 关于妇产科护理论文
β－葡萄糖醛酸苷酶在
母乳性黄疸发病中的关于妇产科护理论文作用
周晓光 杨杰 杨琳琳 吴婕翎
【摘要】 目的关于妇产科护理论文 探讨β-葡萄糖醛酸苷酶(β-gd)在母乳性黄疸发病中的作用。方法 采用酶学比色法对47例母乳性黄疸患儿及60例正常新生儿粪便、血清及其母乳中β-gd活性浓度进行测定，并分析母乳性黄疸患儿β-gd活性浓度与血胆红素浓度的相关性。结果 母乳性黄疸患儿母乳及粪便β-gd活性浓度分别为(1.36±0.30)u/l及(1.07±0.30)u/l，较正常新生儿［(0.75±0.33)u/l及(0.50±0.28)u/l］明显增高，二者之间差异有非常显著意义。患儿母乳及粪便β-gd活性浓度与血胆红素浓度呈明显正相关。黄疸消退期母乳及粪便β-gd活性浓度［(1.11±0.32)u/l及(0.72±0.26)u/l］较高峰期［(1.36±0.30)u/l及(1.07±0.10)u/l］明显降低，二者之间差异有非常显著意义。结论 母乳及粪便β-gd活性浓度增高不仅与母乳性黄疸的发生有关，而且与其严重程度及病程经过密切相关。
【关键词】 黄疸，新生儿 葡糖醛酸酶
an etiological study on breast milk jaundice in neonates zhou xiaoguang*, yang jie, yang linlin, et al. * department of neonatology, maternal and child health hospital of guangdong province, guangzhou 510010
【abstract】 objective to study the relationship between β-glucuronidase (β-gd) and breast milk jaundice.methods breast milk, faecal and serum β-gd activity was measured in 47 infants with breast milk jaundice and 60 healthy infants by using enzymological method. the relationship between β-gd activity and serum bilirubin concentration in infants with breast milk jaundice was analysed.results milk and faecal β-gd activity ［(1.36±0.30) u/l and (1.07±0.30) u/l］ were significantly higher in infants with breast milk jaundice than those in healthy infants［(0.75±0.33) u/l and (0.50±0.28) u/l］, and there was significant difference in β-gd activity between them (p<0.001). high milk and faecal β-gd activity was positively related to raised serum bilirubin concentration in babies with breast milk jaundice (p<0.001 or 0.05). breast milk and faecal β-gd activity ［(1.11±0.32)u/l, and (0.72±0.26)u/l］ was significantly less at fading duration of jaundice than at fastigium of jaundice, and there was statistically significant difference(p<0.001). conclusion high breast milk β-gd activity was not only related to breast milk jaundice, but also to its severity and duration. the results indicate that high milk β-gd activity may be a cause of breast milk jaundice.
【key words】 jaundice, neonatal glucuronidase
母乳性黄疸是新生儿黄疸中较常见的病因，其发生率欧美国家为0.5%～2.6%，日本为10%～15%，我国青岛报告为19.9%［1］。其病因至今尚未定论，多数人认为与母乳中3α、20 β-孕二醇、脂酶对肝脏二磷酸尿甙葡萄糖醛酸转移酶(udpgt)的抑制作用，以及胆红素的肠-肝循环增加有关，后者是目前公认的最有可能的理论［2］。而β-葡萄糖醛酸苷酶(β-glucuronidase, β-gd)在增加胆红素肠-肝循环方面起重要作用［3］。为探讨β-gd在母乳性黄疸发病中的作用，本研究对正常新生儿和母乳性黄疸患儿血清、粪便及其母乳中β-gd活性浓度进行测定，现将结果报告如下。
对象及方法
一、研究对象
1.黄疸组：系我院新生儿科门诊及病房1995年11月～1997年12月所收治的迟发性母乳性黄疸患儿，共47例。其中男性28例，女性19例；日龄为7～47天，平均(16.8±7.7)天；胎龄37～41周，平均(38.7±1.2)周；出生体重2 300～3 900 g，平均(2 986±396) g；无产伤及窒息史。诊断标准依据：(1)完全母乳喂养，在生后一周末出现黄疸，或生理性黄疸持续不退，或生理性黄疸消退后复现；(2)血清胆红素浓度以未结合胆红素升高为主；(3)发育正常，精神、食欲好；(4)排除感染、溶血、缺氧、头颅血肿、肝功能障碍及遗传代谢性疾病等所致的黄疸；(5)停止母乳喂养后黄疸迅速减轻或消退。
|
| | |
| | | | <<<<<全文未完>>>>> 全文字数约3397字 | |
| | |
| |
|
教育论文中心