Value of serum markers in predicting short-term prognosis of neonatal ABO hemolytic jaundice

doi:10.3877/cma.j.issn.1674-0785.2021.06.006

Abstract

Abstract:

Objective

To evaluate the value of serum markers in predicting the short-term prognosis of neonatal ABO hemolytic jaundice.

Methods

Forty-one newborns with ABO hemolytic jaundice admitted to our hospital from January 2018 to December 2020 were selected as the research subjects. According to the prognosis, they were divided into either a poor prognosis group (15 cases) or a good prognosis group (26 cases). All the children were tested for serological indexes on the 3rd and 6th day of life, including red blood cells, hemoglobin (Hb), reticulocytes (Ret), platelets, and total bilirubin (TBIL). The serological indexes of the two groups were compared, and ROC curve analysis was performed to assess the value of single and combined serological indicators in predicting the short-term prognosis of newborns with ABO hemolytic jaundice.

Results

The Hb level in the poor prognosis group was significantly lower than that of the good prognosis group (P＜0.05), and the levels of Ret and TBIL in the poor prognosis group were significantly higher than those of the good prognosis group (P＜0.05). ROC curve analysis showed that Hb, Ret, and TBIL had appreciated predictive value for the short-term prognosis of newborns with ABO hemolytic jaundice, and the areas under the curves were 0.678, 0.753, and 0.695, respectively. The sensitivity, specificity, accuracy, and kappa value of combined detection of Hb, Ret, and TBIL were 73.3%, 88.5%, 82.9%, and 0.627, respectively.

Conclusion

Serum Hb, Ret, and TBIL levels are of great significance in the prediction of short-term prognosis of newborns with ABO hemolytic jaundice, with a higher sensitivity and specificity than each of them alone.

Key words: ABO hemolytic jaundice, Hemoglobin, Total bilirubin, Reticulocytes, Newborns

Juan Zhu, Le Xu, Zhongli. Jiang. Value of serum markers in predicting short-term prognosis of neonatal ABO hemolytic jaundice[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(06): 433-438.

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Figures/Tables 8

项目	预后不良组（15例）	预后良好组（26例）	统计值	P值
胎龄（周， $x ¯$ ±s）	38.95±1.27	38.76±1.68	t=0.456	0.650
性别［例（%）］			χ²=0.017	0.896
男	9（60.00）	19（73.08）
女	6（40.00）	7（26.92）
体质量（g， $x ¯$ ±s）	3195.64±381.25	3249.68±382.60	t=0.523	0.603
发病日龄（d， $x ¯$ ±s）	1.89±0.89	1.94±0.91	t=0.205	0.836
分娩方式［例（%）］			χ²=0.563	0.453
自然分娩	10（66.67）	14（53.85）
剖宫产	5（33.33）	12（46.15）
喂养方式［例（%）］			χ²=0.616	0.735
母乳喂养	3（20.00）	7（26.92）
奶粉喂养	9（60.00）	11（42.31）
混合喂养	3（20.00）	8（30.77）

项目	预后不良组（15例）	预后良好组（26例）	统计值	P值
胎龄（周， $x ¯$ ±s）	38.95±1.27	38.76±1.68	t=0.456	0.650
性别［例（%）］			χ²=0.017	0.896
男	9（60.00）	19（73.08）
女	6（40.00）	7（26.92）
体质量（g， $x ¯$ ±s）	3195.64±381.25	3249.68±382.60	t=0.523	0.603
发病日龄（d， $x ¯$ ±s）	1.89±0.89	1.94±0.91	t=0.205	0.836
分娩方式［例（%）］			χ²=0.563	0.453
自然分娩	10（66.67）	14（53.85）
剖宫产	5（33.33）	12（46.15）
喂养方式［例（%）］			χ²=0.616	0.735
母乳喂养	3（20.00）	7（26.92）
奶粉喂养	9（60.00）	11（42.31）
混合喂养	3（20.00）	8（30.77）

项目	预后不良组（15例）	预后良好组（26例）	t值	P值
WBC（×10⁹/L）	13.41±2.15	13.20±2.24	0.352	0.726
RBC（×10¹²/L）	4.62±1.02	4.57±1.11	0.172	0.864
Hb（g/L）	161.10±24.67	179.10±20.59	2.995	0.004
Ret（%）	3.51±1.21	1.58±1.15	6.081	0.000
MCV（fl）	107.14±9.65	106.81±9.52	0.127	0.899
HCT（%）	26.34±1.16	26.61±1.24	0.824	0.413
RDW-SD（fl）	61.80±5.94	60.31±6.37	0.886	0.379
PLT（×10⁹/L）	277.67±42.65	272.64±41.03	0.446	0.657
TBIL（μmol/L）	159.51±31.64	141.95±30.65	2.092	0.041
DBIL（μmol/L）	16.30±4.23	15.49±4.52	0.678	0.500
ALT（U/L）	9.82±4.10	9.51±4.21	0.275	0.785
AST（U/L）	45.21±25.64	41.54±24.31	0.546	0.587
ALP（U/L）	149.07±34.21	153.67±35.23	0.488	0.626
GGT（U/L）	131.34±23.61	128.61±24.85	0.414	0.681
TBA（U/L）	9.12±2.36	9.20±2.51	0.120	0.905
Alb（g/dl）	3.97±0.34	4.06±0.29	1.074	0.288
cTnI（μg/L）	1.48±0.56	1.42±0.52	0.414	0.680
CK-MB（μg/L）	12.26±5.23	12.51±5.10	0.179	0.858

项目	预后不良组（15例）	预后良好组（26例）	t值	P值
WBC（×10⁹/L）	10.56±1.67	11.20±2.12	1.205	0.233
RBC（×10¹²/L）	4.16±1.02	4.46±1.21	0.970	0.336
Hb（g/L）	148.11±12.34	169.15±14.46	5.674	＜0.001
Ret（%）	3.67±1.24	1.58±0.85	7.617	＜0.001
MCV（fl）	105.06±8.97	106.41±9.62	0.532	0.597
HCT（%）	25.94±1.32	25.61±1.28	0.942	0.351
RDW-SD（fl）	51.02±5.81	50.31±5.67	0.458	0.648
PLT（×10⁹/L）	339.26±40.25	322.64±41.03	1.508	0.137
TBIL（μmol/L）	261.71±38.61	168.95±32.65	9.792	＜0.001
DBIL（μmol/L）	15.83±3.57	15.70±3.23	0.143	0.887
ALT（U/L）	10.32±3.54	9.82±3.10	0.565	0.575
AST（U/L）	26.76±11.21	25.21±11.64	0.499	0.620
ALP（U/L）	152.21±33.51	149.07±34.21	0.342	0.734
GGT（U/L）	151.55±24.61	147.34±23.62	0.648	0.519
TBA（U/L）	14.23±2.54	14.12±2.36	0.167	0.868
Alb（g/dl）	4.20±0.25	4.23±0.28	0.412	0.682
cTnI（μg/L）	1.51±0.45	1.57±0.42	0.514	0.609
CK-MB（μg/L）	11.86±5.52	12.24±5.41	0.258	0.798

项目	曲线下面积	标准误	P值	曲线下面积的95%CI	最佳截断值	敏感度（%）	特异度（%）
Hb	0.678	0.071	0.024	0.539~0.817	145.231 g/L	67.3	74.3
Ret	0.753	0.063	0.001	0.630~0.876	2.824%	70.3	81.3
TBIL	0.695	0.073	0.013	0.551~0.839	218.310 μmol/L	68.9	77.5

Hb+Ret+TBIL	预后不良		合计
Hb+Ret+TBIL	阳性	阴性	合计
阳性	11	3	14
阴性	4	23	27
合计	15	26	41

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