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Objective:To investigate the changes in myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels in neonates with hyperbilirubinemia.Methods:A total of 150 neonates with hyperbilirubinemia who received treatment in the 1 st Affiliated Hospital of Wenzhou Medical University during January-December 2019 were included in this study. They were allocated to mild (total bilirubin level 221-256.5 μmol/L, n = 68) and moderate-to-severe hyperbilirubinemia (total bilirubin level > 256.5 μmol/L, n = 82) groups according to different serum total bilirubin levels. An additional 70 healthy neonates who were born concurrently served as controls. Myocardial enzyme spectrum (creatine kinase, creatine kinase-MB, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase), procalcitonin, and C-reactive protein levels were compared among groups. The correlation between myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels and the severity of hyperbilirubinemia was investigated. The factors related to hyperbilirubinemia in neonates were analyzed using logistic regression analysis. Results:Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were (1130.23 ± 385.42) U/L, (194.82 ± 60.33) U/L, (993.45 ± 271.46) U/L, and (493.76 ± 105.65) U/L, respectively in the moderate-to-severe hyperbilirubinemia group, which were significantly higher than those in the mild hyperbilirubinemia and control groups [(682.23 ± 258.53) U/L, (82.67 ± 24.43) U/L, (486.38 ± 112.57) U/L, (252.63 ± 38.73) U/L; (368.13 ± 104.20) U/L, (27.90 ± 8.29) U/L, (402.13 ± 102.20) U/L, (228.53 ± 34.30) U/L; F = 67.12, 56.23, 66.57, 44.34, all P < 0.01]. Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were significantly higher in the mild hyperbilirubinemia group than those in the control group (all P < 0.05). Premature infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium are the risk factors for neonatal hyperbilirubinemia ( OR = 6.13, 5.40, 5.29, 4.26, 7.79, 6.99, 5.79, 5.44, all P < 0.05). Breastfeeding is an independent protective factor for the development of neonatal hyperbilirubinemia ( OR = 5.87, P < 0.05). Conclusion:Myocardial enzyme, procalcitonin, and C-reactive protein levels increase in neonates with hyperbilirubinemia with the aggravation of the disease. Close monitoring of high-risk factors of neonatal hyperbilirubinemia (including preterm infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium) and strengthening perinatal health care and high-risk pregnancy management can reduce the incidence of pathological jaundice.
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Objective To investigate the correlation of plasma brain natriuretic peptide (BNP) level with serum albumin, serum total bilirubin and thrombin time in patients with liver cirrhosis.Methods RandomLy selected from January 2014 to June 2016 to our hospital diagnosis and hospitalization of 200 cases of cirrhosis patients, according to the standard of Child-Pugh classification provided by Chinese Medical Hepatology Division in 2006, 48 cases were Child A group, 96 cases were Child B group and 56 cases were Child C group.The plasma BNP, serum albumin, serum total bilirubin, prothrombin time and QTc interval of electrocardiogram were analyzed in the clinical data of each group of patients and the correlation between plasma BNP and their correlation.Results The levels of plasma BNP in Child A, B and C groups were higher than those in B group and B group.The correlation between plasma BNP and Child's grade showed a positive correlation, and the results of each group were statistically different (P<0.05).The plasma BNP level was negatively correlated with ALB ( P<0.05 ) .The level of plasma BNP was positively correlated with ALB ( P <0.05 ) .The correlation between plasma BNP and PTIL was correlated with TBIL.The correlation between plasma BNP and TBIL was significantly correlated with TBIL ( P <0.05), The higher the plasma BNP, the regression analysis showed that plasma BNP and TBIL were positively correlated, the difference was statistically significant (P<0.05).The correlation between plasma BNP level and QTc was analyzed.The QTc interval of plasma BNP level was higher than that of the control group ( P<0.01 ) , and the difference was statistically significant ( P <0.01 ) .Conclusion The plasma BNP level in patients with liver function is closely related to ALB, TBIL, PT, QTc interval, and has the value of evaluating and predicting liver function.
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Objective To analyze the reference intervals of serum total bilirubin (TBIL) and serum direct bilirubin (DBIL) by all Chinese clinical laboratories and make a comparison with the upcoming part 4 of Industry Standard WS/T 404.Methods Relevant information about reference intervals of all clinical laboratories participating in TBIL and DBIL testing items of 2014 national external quality assessment scheme of clinical routine chemistry was collected by a web-based external quality assessment software,including source,grouping,verification,upper and lower limits of reference intervals and instruments,reagents,methods and calibrators used.Microsoft Excel 2010 and SPSS 19.0 were applied to statistical analysis.The comparison between reference intervals used and the upcoming Industry Standard was conducted by the simple mean t test.Laboratories derived from the highest percentage of source distribution whose reagent and instrument were matching with each other were grouped according to the test systems used and the differences of reference intervals between three mainly used test systems and the upcoming Industry Standard were also compared with the single sample mean t test.Results The number of laboratories participated in the investigation about source distribution of reference intervals for TBIL and DBIL was 749 and 709 respectively.For these two items,the highest sources were both instructions of reagent(TBIL 58.08％,DBIL 58.67 ％),next were both National Clinical Laboratory Operation Rules (3rd Edition) (TBIL 29.64 ％,DBIL 28.91 ％),the percentages of other sources were all less than 10％.Besides,there were respectively 379 (50.60％) and 354 (49.93％) laboratories verifying their reference intervals for TBIL and DBIL.The difference of the comparison between reference intervals used and the upcoming Industry Standard had statistical significance (P＜0.05).The using reference intervals were narrower than the upcoming Industry Standard for both items.In all laboratories with reference intervals from instructions of reagent,themating laboratories respectively accounted for 41.88％ and 41.48％％ for item TBIL and DBIL.As the single sample mean t test showed,the comparison of the reference intervals between three mainly used test systems in these mating laboratories and the upcoming Industry Standard had statistical significance (P＜0.05),except for the lower limit of DBIL with Beckman test system (P value was 0.068) and the upper limit of DBIL with HITACHI test system (P value was 0.087).Conclusion Currently,the using situation of reference intervals about TBIL and DBIL by all Chinese laboratories was not scientific and rational enough and has significant difference with the upcoming Industry Standard.Should publish the part 4 of Industry Standard WS/T 404 as soon as possible,which would help clinical laboratories establishing suitable reference intervals and promote the standardization of its usage.