Chinese Medical E-ournals Database
Adv Search
中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (04): 431 -437. doi: 10.3877/cma.j.issn.1673-5250.2021.04.009

Original Article

Effects of low-dose vitamin K on serum bilirubin level and hematological indexes of pathological jaundice of premature infants

Yanming Long1,1, Chuanzhong Yang2,2,†(), Guangchun Chen1,1, Qinqin Wu1,1, Jie Zhao1,1, Gengsheng Li1,1, Xiufan Wei3,3   

  • Received:2021-03-09 Revised:2021-07-20 Published:2021-08-01
  • Corresponding author: Chuanzhong Yang
  • Supported by:
    Medical Science and Technology Development Project of National Health Commission(WA2020HK56)
HTML ( ) PDF ( )
Objective

To explore effects of low-dose vitamin K on serum bilirubin level and hematological indexes of pathological jaundice of premature infants (PJPI).

Methods

A total of 68 cases of PJPI in Huizhou No.2 Women′s and Children′s Healthcare Hospital from May 2019 to May 2020 were selected as research subjects, and they were randomly sorted into study group (n=34, received intramuscular injection of low-dose vitamin K 1 mg once-daily for 7 days + blue light therapy for 7 days) and control group (n=34, only received blue light therapy for 7 days) by random digits table method. Serum levels of total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), platelet count, white blood cell count, red blood cell count, hemoglobin (Hb), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and thrombin time (TT) of PJPI in two groups were detected on day 7 of vitamin K treatment or within 24 h before discharge. The above indexes of PJPI in two groups were compared by independent-samples t test or Mann-Whitney U test. This study met requirements of the Ethics Committee of cases collected hospital, and was approved by this committee [approval No. SFYLS(2019)128], and guardians of all premature infants signed clinical research informed consent forms. There were no statistically significant differences in general clinical data of premature infants between two groups, such as gender, body weight and length at admission (P>0.05).

Results

After treatment, comparison results of serum bilirubin levels and hematological indexes of PJPI in two groups were as follows. ①Serum TBIL, DBIL and IBIL concentrations in study group were (130.0±35.6), (18.6±4.7), (111.3±37.4) μmol/L respectively, which were significantly higher than those in control group (152.0±14.7), (21.6±4.8), (130.4±13.7) μmol/L, and all differences were statistically different (t=2.864, 2.668, 2.282; P=0.004, 0.008, 0.023). ②White blood cell count in study group was (8.6±3.5)×109/L, which was significantly lower than that in control group (10.8±2.9)×109/L, and the difference was statistically significant (t=2.811, P=0.005). However, platelet count, red blood cell count and serum Hb level showed no statistically differences between two groups (P>0.05). ③There were no statistically significant differences in APTT, PT, Fib and TT between two groups after treatment (P>0.05).

Conclusions

Intramuscular injection of low-dose vitamin K combined with blue light therapy can effectively reduce serum level of bilirubin and white blood cell count of PJPI, and control the progress of pathological jaundice. Vitamin K may be a potential clinical strategy for treatment of PJPI.

Key words: Vitamin K, Jaundice, neonatal, Bilirubin, Leukocyte count, Infant, premature
表1 治疗后，2组PJPI血清TBIL、DBIL及IBIL浓度比较(μmol/L，±s)
组别 例数 TBIL DBIL IBIL
研究组 34 130.0±35.6 18.6±4.7 111.3±37.4
对照组 34 152.0±14.7 21.6±4.8 130.4±13.7
t值   2.864 2.668 2.282
P值   0.004 0.008 0.023
表2 治疗后，2组PJPI血常规指标比较
组别 例数 血小板计数[×109/L，M(P25~P75)] 白细胞计数(×109/L，±s) 红细胞计数[×1012/L，M(P25~P75)] Hb[g/L，M(P25~P75)]
研究组 34 317.4(259.0~391.7) 8.6±3.5 3.8(3.4~4.4) 132.5(117.7~150.7)
对照组 34 311.2(262.0~405.0) 10.8±2.9 4.0(3.6~4.6) 134.6(119.0~155.0 )
检验值   Z＝0.926 t＝2.811 Z＝1.057 Z＝0.401
P值   0.354 0.005 0.291 0.689
表3 治疗后，2组PJPI凝血功能指标比较(±s)
组别 例数 APTT(s) PT(s) TT(s) Fib(g/L)
研究组 34 52.8±8.3 17.3±2.1 19.9±1.3 1.8±0.5
对照组 34 48.9±5.6 16.4±2.1 19.2±1.1 2.1±0.3
t值   2.002 1.592 1.946 1.810
P值   0.052 0.111 0.059 0.078
[1]
刘晓燕，王亚彬，信雅威，等. 茵苓健脾退黄汤泡浴结合蓝光照射治疗新生儿黄疸临床观察[J]. 中华中医药学刊，2020, 38(7): 232-235. DOI: 10.13193/j.issn.1673-7717.2020.07.05.
[2]
苏州市疾病预防控制中心，上海市疾病预防控制中心，杭州市疾病预防控制中心，等. 特殊健康状态儿童预防接种专家共识之十一——婴儿黄疸与预防接种[J]. 中国实用儿科杂志，2019, 34(2): 87-88. DOI: 10.19538/j.ek2019020605.
[3]
张雷，董巧丽. 胆红素的变化与新生儿黄疸发生程度的相关性[J]. 中国妇幼健康研究，2018, 29(6): 738-741. DOI: 10.3969/j.issn.1673-5293.2018.06.015.
[4]
Bedu A, Renesme L, Tourneux P, et al. Recommendations for the management of neonatal jaundice: from the term new born to the premature baby: a challenge for the French Society of Neonatology[J]. Arch Pediatr, 2017, 24(2): 97-99. DOI: 10.1016/j.arcped.2016.11.014.
[5]
Wu YW, Kuzniewicz MW, Croen L, et al. Risk of autism associated with hyperbilirubinemia and phototherapy[J]. Pediatrics, 2016, 138(4): e20161813. DOI: 10.1542/peds.2016-1813.
[6]
金姣，陈亚军. 新生儿黄疸对心功能及凝血功能影响的临床分析[J]. 中国卫生检验杂志，2018, 28(18): 2255-2257.
[7]
刘国辉，冯永瑜，黄书炜. 凝血功能在新生儿黄疸中的临床意义分析[J]. 中国实用医药，2020, 15(18): 79-80. DOI: 10.14163/j.cnki.11-5547/r.2020.18.035.
[8]
陈柱荣. 黄疸型肝炎患儿采用维生素K与消旋山莨菪碱联合治疗的效果分析[J/CD]. 中国医学前沿杂志(电子版), 2014, 6(11): 104-106. DOI: 10.3969/j.issn.1674-7372.2014.11.039.
[9]
邵肖梅，叶鸿瑁，丘小汕. 实用新生儿学[M]. 4版，北京：人民卫生出版社，2011: 240.
[10]
杨小娟，潘关凤，王平蓝. 保温箱内蓝光治疗早产儿黄疸时体温调节护理研究[J]. 现代医药卫生，2020, 36(11): 1631-1633. DOI: 10.3969/j.issn.1009-5519.2020.11.009.
[11]
汤晶晶. 茵栀黄颗粒联合蓝光治疗新生儿黄疸的临床效果观察与分析[J]. 中华全科医学，2015, 13(4): 611-613. DOI: 10.16766/j.cnki.issn.1674-4152.2015.04.051.
[12]
王淑秀，梁彩平. 早产儿86例护理体会[J]. 中国社区医师，2013, 15(4): 330-331. DOI: 10.3969/j.issn.1007-614x.2013.04.318.
[13]
王雅晶. 早产儿护理方法的探讨[J]. 中国社区医师，2012, 14(11): 441. DOI: 10.3969/j.issn.1007-614x.2012.11.419.
[14]
梅国花，方斌豪，孙书丽，等. 新生儿黄疸非结合胆红素及血清白蛋白检测的应用价值分析[J]. 中国妇幼保健，2015, 30(15): 2369-2371. DOI: 10.7620/zgfybj.j.issn.1001-4411.2015.15.29.
[15]
陈海云，崔华英，陈博文. 间歇蓝光照射联合静脉滴注白蛋白治疗新生儿病理性黄疸患儿的临床疗效[J/CD]. 中华妇幼临床医学杂志(电子版), 2019, 15(5): 579-584. DOI: 10.3877/cma.j.issn.1673-5250.2019.05.016.
[16]
古丽，黄薇，董文斌，等. 早产儿高胆红素血症与肾损伤的关系研究[J/CD]. 中华妇幼临床医学杂志(电子版), 2016, 12 (1): 62-66. DOI: 10.3877/cma.j.issn.1673-5250.2016.01.011.
[17]
霍少凯. 慢性肝衰竭中医证型分析及维生素K1干预作用的研究[D]. 长春：长春中医药大学，2019. DOI：10.26980/d.cnki.gcczc.2019.000440.
[18]
国庆军. 维生素K1治疗急性黄疸型肝炎60例[J]. 中国社区医师，1993, 9(6): 39.
[19]
田爱存，尹彦姝，宋存红，等. 白细胞计数、超敏C反应蛋白、降钙素原对病理性黄疸患儿感染的诊断价值[J]. 实用临床医药杂志，2016, 20(9): 174-175. DOI: 10.7619/jcmp.201609062.
[20]
苏文，陆化，洪鸣，等. 阻塞性黄疸起病的急性白血病1例报道[J]. 南京医科大学学报(自然科学版), 2012, 32(1): 153-154.
[21]
付纳新，徐建英，刘俊芬. 母乳性黄疸患儿血清总胆红素和胆汁酸测定的临床意义[J/CD]. 中华妇幼临床医学杂志(电子版), 2013, 9(1): 85-86. DOI: 10.3877/cma.j.issn.1673-5250.2013.01.019.
[22]
魏丽华，王亚亭，李忠强，等. 维生素K1对哮喘大鼠IL-4水平及ICAM-1表达的影响[J]. 临床儿科杂志，2013, 31(2): 175-177. DOI : 10.3969/j.issn.1000-3606.2013.02.021.
[23]
谢煜，姚珍薇，杨帆. 雌激素和维生素K抗去势成年雌性大鼠骨质疏松的实验研究[J/CD]. 中华妇幼临床医学杂志(电子版), 2009, 5(3): 226-231. DOI: 10.3877/cma.j.issn.1673-5250.2009.03.106.
[24]
高彩云，王敏，张光. 新生儿溶血病患儿血浆组织纤溶酶原激活物和纤溶酶原激活物抑制物变化的研究[J]. 河北医药，2012, 34(12): 1793-1795. DOI: 10.3969/j.issn.1002-7386.2012.12.015.
[25]
白羽. 新生儿黄疸与凝血酶原时间、活化部分凝血酶原时间延长的相关性及临床价值[J]. 中国医学创新，2019, 16(34): 47-50. DOI: 10.3969/j.issn.1674-4985.2019.34.012.
[26]
郭妍南，明华，陈秀英，等. 枸橼酸钠抗凝在脓毒症伴急性肾损伤患儿连续性静脉-静脉血液滤过治疗中的应用[J/CD]. 中华妇幼临床医学杂志(电子版), 2016, 12(6): 726-730. DOI: 10.3877/cma.j.issn.1673-5250.2016.06.020.
[27]
陈静，洪燕英，童新元，等. 血栓弹力图常用参数与凝血因子及凝血象相关性分析[J]. 国际检验医学杂志，2020, 41(9): 1082-1085. DOI: 10.3969/j.issn.1673-4130.2020.09.014.
[28]
敖正才，王潞雪. 重症监护室患者输注血浆前后PT和APTT值的变化及疗效分析[J]. 临床血液学杂志，2020, 33(4): 281-283. DOI: 10.13201/j.issn.1004-2806-b.2020.04.014.
[29]
殷炽龙. 维生素K1在新生儿早期凝血功能异常中的应用研究进展[J]. 中国医学创新，2019, 16(36): 166-169. DOI: 10.3969/j.issn.1674-4985.2019.36.042.
[30]
姚发华，黄栋，王予川. 儿童抗凝血灭鼠药中毒临床分析[J/CD]. 中华妇幼临床医学杂志(电子版), 2017, 13(6): 715-720. DOI: 10.3877/cma.j.issn.1673-5250.2017.06.017.
[31]
涂彩霞，任丹阳，李云巍，等. 维生素K1注射液给药途径的分析与思考[J]. 海峡药学，2019, 31(2): 271-272. DOI: 10.3969/j.issn.1006-3765.2019.02.145.
[32]
李孜，付平，周莉，等. 肌肉注射维生素K1过敏的临床证据[J]. 中国循证医学杂志，2005, 5(8): 641-643, 647. DOI: 10.3969/j.issn.1672-2531.2005.08.012.
[33]
梁雁，鲁云兰. 儿童药物不良反应及相关因素[J]. 儿科药学杂志，2008, 14(3): 9-11. DOI: 10.13407/j.cnki.jpp.1672-108x.2008.03.009.
[1] Guocheng Wang, Yajing Liu, Yaguang Peng. Reference intervals and its dynamic changes of four indexes of blood routine test of preschool children in Shunyi district, Beijing[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(02): 187-193.
[2] Airun Zhang, Jialiang Zhao, Guanming Li, Jiahong Li, Jingrong Chen, Lan Wang, Siqi Zhuang, Xiaoyi Fang. Hemolytic disease of newborn due to RhE and Rhc incompatibility in premature infant: a case report and literature review[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(01): 93-99.
[3] Shuhui Wang, Mei Xue. Research status of early monitoring of brain injury caused by neonatal hyperbilirubinemia[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(06): 634-642.
[4] Guoyu Liu, Hongtao Fu, Guijun Hou. Application value of smartphone application in detecting neonatal bilirubin level[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(02): 226-233.
[5] Liting Chen, Huiping Liu, Zhongrui Song, Shang Xu, Yuxiu Guo, Guihua Shu. Early predictive value of score of modified amplitude integrated electroencephalogram combined with serum level of neuron specific enolase in newborns with neonatal bilirubin brain injury[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(04): 430-437.
[6] Haiyun Chen, Huaying Cui, Bowen Cheng. Clinical effect of intermittent blue light phototherapy combined with intravenous infusion of albumin on neonatal pathological jaundice[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(05): 579-584.
[7] Xiang Gao, Chengjun Zhao, Shihong Hu. Short-term prognostic value of age-bilirubin-international normalized ratio-creatinine score in patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2022, 16(02): 108-114.
[8] Qi Zhang, Aizhong Xu, Dongshu Wang, Yongsheng Wang. Effects of different CO2 pneumoperitoneal pressure on inflammatory response after laparoscopic upper gastrointestinal perforation repair[J]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(04): 278-282.
[9] Youxin Wei, Yuanping Wu, Baisheng Chen, Changying Xing. Study on the correlation between serum dp-ucMGP level and vascular calcification in maintenance hemodialysis patients[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2021, 10(06): 311-316.
[10] Huiying Wang, Min Su, Xiangyu Gao, Bo Yang, Yi Ren, Li Li, Dandan Zhao, Di Huang. Effect of hyperbilirubinemia on the kidneys of newborn rats[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2021, 10(02): 75-80.
[11] Liangliang Guo, Shanshan Qiu, Ping Zhong, Xinkai Zhao. Diagnostic value of PALBI score in upper gastrointestinal bleeding in cirrhotic patients[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 216-219.
[12] Nianyu Xue, Shengmin Zhang, Lingheng Wu, Lei Sha, Lanyue Tong, Cuiqin Shen, Zhaojun Li, Lianfang Du. Effect of serum bilirubin on myocardial function in patients with type 2 diabetes before cardiac structural changes[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 1004-1009.
[13] Juan Zhu, Le Xu, Zhongli. Jiang. Value of serum markers in predicting short-term prognosis of neonatal ABO hemolytic jaundice[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(06): 433-438.
[14] Jianmei Zhang, Fasheng Liu, Xin Chen, Zhenhua Zhu. Immune changes in neonates with hyperbilirubinemia on different phototherapies[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(02): 94-98.
[15] Tingting Yu, Dong Pu, Dongling Li, Hongying Wang, Runwu Zhang, Caimei Ding, Lihua Li, jing Bai, Xiaofei Li. Analysis of genotype and PIVKA-II level of Patients with HBV-related hepatocellular carcinoma in Kunming[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2020, 08(03): 166-169.
Viewed
Full text


Abstract

Copyright © Chinese Medical Association, Chinese Medical Multimedia Press  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号