新生兒膽紅素代謝-《兒科學(xué)》精品課件華西8年制

1、Chen Dapeng MD, PhD Pediatric Department West China Second University Hospital,Neonatal Bilirubin Metabolism,To understand the characteristics of neonatal bilirubin metabolism.,Objective,Jaundice(黃疸),Yellowish staining of the skin and whites of the eyes by bilirubin.,Term baby (37w) 50%,Incidence in

2、 Newborn,Preterm baby(37w) 80%,Core of Bilirubin Metabolism,Unconjugated bilirubin (未結(jié)合膽紅素),Conjugated bilirubin （結(jié)合膽紅素）,glucuronic acid （葡萄糖醛酸）,Metabolism of Bilirubin,Metabolism of Bilirubin,Red Blood Cell,Increase of bilirubin production Adult 3.8mg/L Newborn 8.5mg/L,RBC life span,120 d,80 d,RBC

3、Quantity,4.5x1012/L,6.5x1012/L,2.Lack of Albumin(白蛋白),3.Poor hepatic function,Unconjugated Bilirubin,Y/Z Protein(Y/Z蛋白),Unconjugated Bilirubin,glucuronyl transferase(葡萄糖醛酸轉(zhuǎn)移酶),Conjugated bilirubin,4.Increasing of Enterohepatic circulation (腸肝循環(huán)),Enterohepatic circulation Definition: Circulation of b

4、ilirubin, which was absorbed from the intestine and carried to the liver, where it was secreted into the bile and again enter the intestine.,Neonatal Enterohepatic circulation,Glycuronidase 葡萄糖醛酸苷酶,Increase of bilirubin production Lack of albumin Poor hepatic function Increase of enterohepatic circulation,Summary of Neonatal Bilirubin Metabol