Neonatal Jaundice 新生儿黄疸 Neonatal Hyperbilirubinemia 新生儿高胆红素血症
Neonatal Hyperbilirubinemia 新生儿高胆红素血症 Neonatal Jaundice 新生儿黄疸
bilirubin metabolism RBC Hb Bilirubin(胆红素) Free bilirubin(游离胆红素)
RBC Hb Bilirubin ( 胆红素) Free bilirubin (游离胆红素) bilirubin metabolism
Breakdown of Unconjugated bilirubin haemoglobin bound to albumin and other haem proteins Unconjugated bilirubin (未结合胆红素) Transport, Uptake Conjugation (glucuronyl transferase) Conjugate Conjugated bilirubin Conjugated bilirubin (结合胆红素) Excretion in bile Excretion Enterohepatic Stercobilinogen circulati
Unconjugated bilirubin (未结合胆红素) Transport, Uptake Conjugate Conjugated bilirubin (结合胆红素) Excretion
Neonatal bilirubin metabolism 1. ncreased bilirubin load on liver cell a Increased rbc volume b, Decreased rbc survival C Increased early-labeled bilirubin d Increa sed enterohepatic circulation of bilirubin
Neonatal bilirubin metabolism 1. Increased bilirubin load on liver cell a. Increased RBC volume b. Decreased RBC survival c. Increased early-labeled bilirubin d. Increa sed enterohepatic circulation of bilirubin
Neonatal bilirubin metabolism (Contd 2. Defective hepatic uptake of bilirubin from plasma a Decreased ligandin (Y and z protein b Binding of ligandin by other anions
Neonatal bilirubin metabolism (Contd.) 2. Defective hepatic uptake of bilirubin from plasma a. Decreased ligandin (Y and Z protein) b. Binding of ligandin by other anions
Neonatal bilirubin metabolism (Contd.) 3. Defective bilirubin conjugation a Decreased uridine diphosphate glucuronyl transferase(UDPG-T)activity 葡萄糖醛酸转移酶 b Increased uridine diphosphoglucose dehydrogenenase(B-glucuronidase)activity
Neonatal bilirubin metabolism (Contd.) 3. Defective bilirubin conjugation a. Decreased uridine diphosphate glucuronyl transferase (UDPG-T) activity 葡萄糖醛酸转移酶 b. Increased uridine diphosphoglucose dehydrogenenase (-glucuronidase) activity
Neonatal bilirubin metabolism (Contd.) 4 Decreased excretion of bilirubin Summary a Increased bilirubin production Decreased clearance of bilirubin
Neonatal bilirubin metabolism (Contd.) 4. Decreased excretion of bilirubin Summary: Increased bilirubin production Decreased clearance of bilirubin
Physiologic Jaundice Onset of jaundice: 2-3 days of age I The time of peak level: 4-6 days of age I The resolving time Full term: 2 weeks of age Preterm:3-4 weeks of age 1 Level of total serum bilirubin: <12mg/dL 1 Level of conjugated bilirubin: <1.5mg/dL
Physiologic Jaundice Onset of jaundice: 2-3 days of age The time of peak level: 4-6 days of age The resolving time: Full term: 2 weeks of age Preterm: 3-4 weeks of age Level of total serum bilirubin: <12mg/dL Level of conjugated bilirubin: <1.5mg/dL
Physical jaundice in full Term Infant
Physical Jaundice in Full Term Infant
Nonphysiologic Jaundice 1 Onset of jaundice: before 24 hours of age 1 Any elevation of serum bilirubin that requires phototherapy A rise of serum biliru bin levels of over 5mg/dL/day I Signs of underlying illness ■ Persist jaundice
Nonphysiologic Jaundice Onset of jaundice: before 24 hours of age Any elevation of serum bilirubin that requires phototherapy A rise of serum bilirubin levels of over 5mg/dL/day Signs of underlying illness Persist jaundice
