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1、The Metabolic Characteristics of Bilirubin in Newborns,Wu jinlinDepartment of PediatricsWest China Second University Hospital Sichuan University,Baby on Phototherapy,Introduction of Neonatal Jaundice,Jaundice is quite common in neonatal period,1 60%of term infants and 80%of preterm infants,2 Visible
2、 jaundice from sclera,mucosa and skin,Introduction of Neonatal Jaundice,Can cause serious consequences,1 Actue phase,2 lifelong neurologic sequelae kernicterus,Why jaundice is so prevalent in neonatal period?,Normal Bilirubin Metabolism,Whats the distinct metabolic characteristics of bilirubin in ne
3、wborns comparing with our adults?,1.Increased bilirubin production in newborns,2.Insufficient binding between bilirubin and albumin,3.Deficient bilirubin conjugation in the hepatocyte,4.Increased enterohepatic circulation of bilirubin,Neonatal Bilirubin Metabolism,5.Others,2 Turnover rate of neonata
4、l hemoglobin:2 times faster than that of adults,(3)Over production of shunt bilirubin,1.Increased bilirubin production,1.Increased bilirubin production in newborns,2.Insufficient binding between bilirubin and albumin,3.Deficient bilirubin conjugation in the hepatocyte,4.Increased enterohepatic circu
5、lation of bilirubin,Neonatal Bilirubin Metabolism,5.Others,2.Insufficient Binding between Bilirubin and Albumin,1.Increased bilirubin production in newborns,2.Insufficient binding between bilirubin and albumin,3.Deficient bilirubin conjugation in the hepatocyte,4.Increased enterohepatic circulation
6、of bilirubin,Neonatal Bilirubin Metabolism,5.Others,3.Deficient Bilirubin Conjugation in the Hepatocyte,1.Increased bilirubin production in newborns,2.Insufficient binding between bilirubin and albumin,3.Deficient bilirubin conjugation in the hepatocyte,4.Increased enterohepatic circulation of bilir
7、ubin,Neonatal Bilirubin Metabolism,5.Others,4.Increased Enterohepatic Circulation of Bilirubin,intestinal flora is not fully developed,abundant-glucuronidase,delayed excretion of meconium,1.Increased bilirubin production in newborns,2.Insufficient binding between bilirubin and albumin,3.Deficient bilirubin conjugation in the hepatocyte,4.Increased enterohepatic circulation of bilirubin,Neonatal Bilirubin Metabolism,5.Others,5.Others,dehydration,acidosis,intracranial hemorrhage,cephalohematoma,hypoxia,Summary,1 Jaundice is much more frequent in neonates,Thank you,
