β-葡萄糖醛酸苷酶测定在母乳性黄疸诊断中的价值

    Value of β-glucuronidase measurement in diagnosis of breast-milk jaundice

    • 摘要: 目的: 测定母乳及新生儿粪便中β-葡萄糖醛酸苷酶(β-GD)水平,探讨其在母乳性黄疸发病中的作用及诊断中的价值。方法: 将纯母乳喂养的60例母乳性黄疸患儿和70例正常新生儿为观察对象,于生后第7、14、21、28天测定母乳、新生儿粪便及血清中β-GD活性和血清胆红素水平。分析母乳和新生儿粪便β-GD测定在母乳性黄疸患儿的阳性率。结果: 母乳中β-GD活性和新生儿粪便中β-GD活性在母乳性黄疸组与正常新生儿组各时期差异有统计学意义(P<0.001);母乳性黄疸组血清胆红素水平与母乳、新生儿粪便中β-GD活性的相关系数分别为0.785和0.753(P<0.01),呈明显正相关。两组母乳β-GD测定的阳性率分别为80.0%和7.1%,差异有统计学意义(P<0.005),其灵敏度、特异度、阳性预测值、阴性预测值及诊断正确率分别为80.0%、92.9%、90.6%、84.4%及86.9%。两组新生儿粪便测定的阳性率分别为78.3%与5.7%,差异有统计学意义(P<0.005),其灵敏度、特异度、阳性预测值、阴性预测值及诊断正确率分别为78.3%、94.3%、92.2%、83.5%及86.9%。结论: β-GD活性在母乳性黄疸的发病机制中起重要作用,母乳及新生儿粪便β-GD测定在母乳性黄疸诊断中具有一定的实用价值。

       

      Abstract: Objective: To study the role of β-glucuronidase(β-GD) in breast-milk jaundice in neonates and its diagnostic vaule.Methods: The study was conducted on 60 neonates with breast-milk jaundic(study group) and 70 healthy newborns(control group).The β-GD activity and the serum total bilirubin concentration was estimated in the breast milk and the infants' feces at day 7,14,21 and day 28.The positive rates of β-GD activity in the breast-milk jaundic were determined at the same time points.Results: The difference of β-GD activities in the study group and the control group had statistical significance(P<0.001).The infant fecal β-GD activities at each time point was obviously different between the two groups(P<0.001).The serum total bilirubin levels had positive correlation to the β-GD activities both in breast milk and infant faces in the study group and the correlation coefficients were 0.785 and 0.753,respectively(P<0.01).The positive rates of milk β-GD in infants with breast milk jaundice and healthy newbrons were 80.0% and 7.1% respectively.The difference was significant(P<0.005).Its sensitivity,specificity,positive predicting value,negative predicting value and correct diagnostic rate were 80.0%,92.9%,90.6%,84.4%,and 86.9%,respectively.The positive rates of fecal β-GD measurement in babies with breast-milk jaundice and healthy newbrons were 78.3% and 5.7% respectively.The difference was significant(P<0.005).Its sensitivity,specificity,positive predicting value,negative predicting value and correct diagnostic rate were 78.3%,94.3%,92.2%,83.5% and 86.9%,respectively.Conclusions: β-GD activity plays an important role in breast-milk jaundice in neonates.The measurement of β-GD in breast-milk and infants'feces is of value for diagnosis of breast-milk jaundice.

       

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