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Abstract
Objective To assess the impact of phototherapy as the risk factor on the reduction of serum globulin in neonatal hyperbilirubinemia.
Methods Total of 430 full term infants aged at 1–28 days diagnosed with neonatal hyperbilirubinemia was enrolled in this study. Intrauterine infection, genetic abnormal and congenital diseases was excluded. All newborns received single-side phototherapy (halogen lamps for 12 h per day, 3 days) or plus intravenous albumin (1 g/kg.d, two days) or plus intravenous immuneglobulin (1 g/kg.d, two days). The total serum bilirubin (TSB), albumin (ALB) and globulin (GLB) levels were detected twice at the first day and fourth day of hospitalisation respectively.
Results TSB concentrations decreased from 299.6 ± 83.9 μmol to 163.6 ± 57.6 μmol/L after three days intensive treatment (p < 0.001). Pearson correlative analysis shows that TSB is significant correlated to GLB level (r = 0.245, p < 0.01) and not related to ALB. There was a significant reduction of GLB levels in each age groups after treatment (p < 0.001). The GLB concentrations decreased 2–4 g/L (10–20% compared to their basic levels) and dramatically decreases in groups of >7 days of birth age (p < 0.001). The reductions of GLB level were from 21.3 ± 4.1 g/L to 18.5 ± 4.2 g/L in phototherapy group, and 23.0 ± 3.9 g/L to 16.6 ± 4.5 g/L in phototherapy plus IVALB (p < 0.001). The effect of phototherapy on reduction of GLB levels was correlated to the ages of birth.
Conclusions These results demonstrated that phototherapy accelerates serum globulin clearance which implies infants facing to the risk of immunity injure, especially in age over 16 days, while additional IVALB aggravated the reduction along with the ages.
