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目的评估高胆红素血症对新生儿自发性眨眼的影响。方法采用新生儿行为神经(NBNA)评分法、5分钟眨眼试验,检测评估53例高胆红素血症新生儿,按小时胆红素值分为高胆1组(>小时胆红素第75百分位值)和高胆2组(>小时胆红素第95百分位值),在黄疸消退后重复上述两项测评,并与38例同日龄正常新生儿对照。结果 (1)高胆红素血症新生儿NBNA评分明显低于正常同日龄新生儿,且自发性眨眼明显增多,差异有统计学意义(P<0.05)。(2)高胆红素血症新生儿在黄疸消退后,NBNA评分和自发性眨眼频率较黄疸高峰期有所恢复,结果差异有统计学意义(P<0.01)。(3)黄疸消退后高胆1组与同日龄的正常新生儿比较,NBNA评分和5分钟自发性眨眼频率差异无统计学意义(P值均>0.05)。而高胆2组NBNA总分包括原始反射、一般评估仍明显低于正常同龄新生儿(P<0.01);自发性眨眼频率仍较同日龄新生儿增多(P<0.05)。(4)黄疸消退后高胆1组的NBNA评分、自发性眨眼恢复较好,与高胆2组比较差异有统计学意义(P<0.05)。结论高胆红素血症可影响新生儿的行为表现和自发性眨眼频率,其影响程度与黄疸严重度有关。
Objective To evaluate the effect of hyperbilirubinemia on spontaneous blink in newborns. Methods Neonatal behavioral neurobehavioral (NBNA) scoring method and 5-minute blinking test were used to detect and evaluate 53 newborns with hyperbilirubinemia. The hourly bilirubin values were divided into high cholecystokinin group 1 (> 75 h bilirubin 75 Percentile) and high bile 2 (> hour bilirubin 95th percentile). The above two items were repeated after jaundice subsided, and were compared with 38 normal neonates of the same age. Results (1) NBNA score of neonates with hyperbilirubinemia was significantly lower than that of normal neonates of the same age, and spontaneous blinks were significantly increased (P <0.05). (2) After neonates with hyperbilirubinemia subsided, the NBNA score and spontaneous blink frequency recovered at the peak of jaundice, the difference was statistically significant (P <0.01). (3) There was no significant difference between NBNA score and 5-minute spontaneous blink frequency in jaundice hypercholesterolemia group 1 and normal neonates with the same age (all P values> 0.05). However, the total score of NBNA in both groups was significantly lower than that of normal peers (P <0.01). The spontaneous blink frequency was still higher than that of neonates with the same age (P <0.05). (4) NBNA score of high bile group after jaundice subsided was better than spontaneous blink recovery, and there was significant difference between high bile 2 group and jaundice (P <0.05). Conclusions Hyperbilirubinemia can affect the neonatal behavior and spontaneous blink frequency, the extent of which is related to the severity of jaundice.