- 期刊
Serum γ-Glutamyl Transpeptidase Activity and Neonatal Hyperbilirubinemia in Chinese Newborns
中國新生兒黃疸疽與血清丙麩氨轉肽酶活性之關係
摘要
本研究測定209位健康產婦之正常新生兒之臍靜脈血清及産後第四天新生兒血清中丙麩氨轉肽酶γ-Glutamyl Transpeptidase(γ-GT)之活性，以探討其與新生兒黃疸程度之關係。其結果如下： 209位受檢新生兒之臍脈血清及産後第四在新生兒血清中γ-GT活性之平均值分別爲75.00±39.67U/L，及48.18±29.41U/L。在受檢新生兒血清總膽紅素高峯值爲低於7mg/dl，7至15mg/dl，及高於15mg/dl之各組中，其臍靜脈血清及産後第四天新生兒血清中γ-GT之活性分別爲：43.80±18.20U/L及30.75±17.95U/L；69.92±30.27U/L及45.52±26.89U/L；118.52±53.48U/L及71.33±33.94U/L。於臍靜脈血清及産後第四天新生兒血清中γ-GT活性在各組間之差異皆有統計學上之意義。新生兒其個別血清總膽紅素高峯值與臍靜脈血清及産後第四天新生血清γ-GT之活性間亦皆呈有意義之正關係。 若依臍靜脈血清γ-GT活性分成：低於35U/L，35至115U/L，及高於115U/L等三組，則各組新生兒之血清總膽紅素高峯值之平均值分別爲9.48±2.88mg/dl，11.00±2.91mg/dl，及14.35±2.83mg/dl，其各組間之差異亦有統計學上之意義。 本研究中，同時測定了32組臍靜脈，臍動脈，及産婦血清中γ-GT之活性，其平均值分別爲：86.44±41.55U/L，82.72±39.82U/L，及5.19±3.16U/L。γ-GT活性於産婦血清很顯著低於臍帶血清。臍靜脈血清γ-GT之活性略高於臍動脈血清者，但此差異並無統計學之意義。 本研究之結論認爲，新生兒血清γ-GT活性之上升乃由於肝臟microsome系統之異常所引起，此種異常可能與新生兒肝臟未成熟之程度有關，而血清膽紅素的排泄也因爲不同程度的此種肝機能障礙而受到限制，造成不同程度之新生兒黃疸。 因此新生兒不成熟之肝臟機能乃是影響中國新生兒膽紅素血症之主要原因之一。此外，由於γ-GT於肝功能檢查術爲敏感，臨床上可測定其在臍帶血中之活性，用來評估新生兒肝臟之成熟度，並早期預測新生兒黃疸之程度。
關鍵字
無資料並列摘要
To assess the role of the hepatic function in neonatal jaundice, γ-Glutamyl Transpeptidase (γ-GT) activity in cord blood and day 4 serum were measured in 209 normal Chinese newborns. The mean (±SD) levels of cord venous serum γ-GT activity was 75.00±39.67 U/L. The enzyme activity for those infants with peak serum bilirubin levels (A) below 7 mg/dl, (B) between 7 and 15 mg/dl (C) above 15 mg/dl, were 43.80±18.20 U/L, 69.92±30.27 U/L and 118.52±53.48 U/L respectively. There were significant differences exist among these 3 groups (P＜0.01). The mean (±SD) levels of day 4 serum γ-CT activity was 48.18±29.41 U/L, and the enzyme activities for groups A, B and C were 30.75±17.95 U/L, 45.52±26.89 U/L and 71.33±33.94 U/L respectively. There were statistically significant differences exist among these 3 groups (P＜0.01). 32 suits of cord venous arterial and maternal serum were also simultaneously assessed for γ-GT activity. The mean (±SD) serum γ-GT levels for the 32 suits were cord vein, 86.44+41.55 U/L; cord artery, 82.72±39.82 U/L; and maternal 5.19±3.16 U/L, No significant difference exists between the cord venous and arterial serum, [he relationship of the γ-GT level between the cord and maternal serum in individual cases showed no correlation statistically. Our results suggest that increased serum γ-CT activity in lice neon ate may reflect hepatic microsomal dysfunction with subsequent impairment of bilirubin conjugation. Therefore, the finding of increased cord serum γ-GT activity may serve as an early index of impending hyperbilirubinemia.