Objective: To investigate the diagnostic values of prealbumin (PAB) and retinol-binding protein (RBP) for liver damage caused by mild or severe asphyxia.
Methods: A retrospective analysis was performed on 185 neonates (including 84 premature infants and 101 full-term infants) with asphyxia. Based on the Apgar score, they were divided into two groups: mild asphyxia group (n=150) and severe asphyxia group (n=35). The levels of PAB, RBP, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured and compared. Their diagnostic values for liver damage were evaluated by ROC curve analysis.
Results: The premature infants in the severe asphyxia group had significantly higher AST level and significantly lower levels of PAB and RBP than those in the mild asphyxia group (P<0.05). The full-term infants in the severe asphyxia group had a significantly lower PAB level than those in the mild asphyxia group (P<0.05). After treatment, the PAB level was significantly improved in the premature infants in the severe asphyxia group and in the full-term infants in both mild and severe asphyxia group (P<0.05). The full-term infants in the mild asphyxia groups also showed a significant improvement in AST level (P<0.05). The ROC curve analysis showed that PAB had a good sensitivity and specificity for identifying liver damage caused by mild or severe asphyxia in full-term and preterm infants.
Conclusions: PAB can be used as an indicator of liver damage caused by asphyxia in neonates, and can be used to assess the degree of asphyxia.
目的: 探究前白蛋白（PAB）及视黄醇结合蛋白（RBP）对于鉴别轻、重度窒息新生儿的肝损害诊断价值。
方法: 回顾性分析185例窒息新生儿，依据Apgar评分，分为轻度和重度窒息组，对不同窒息程度早产儿（84例）、足月儿（101例）的PAB、RBP、谷丙转氨酶、谷草转氨酶进行比较，并进行ROC曲线分析。
结果: 与轻度窒息组比较，重度窒息组早产儿的谷草转氨酶较高，PAB、RBP较低（P < 0.05）；重度窒息组足月儿的PAB较低（P < 0.05）。与治疗前比，治疗后早产儿重度窒息组的PAB，足月儿轻度窒息组的AST、PAB和重度窒息组的PAB均明显好转（P < 0.05）。ROC曲线显示，前白蛋白对于窒息足月儿、早产儿肝功能损害评价均有较好的灵敏度及特异度。
结论: 前白蛋白可作为评价新生儿窒息肝损害的指标，并可以用于判断窒息程度的不同。