Exploration of the pathogenic factors of neonatal jaundice and the clinical effect of blue phototherapy

Abstract

Objective: To study the pathogenic factors of neonatal jaundice and the clinical effect of blue light phototherapy.

Methods: We selected 240 children with neonatal jaundice admitted to our hospital from January 2018 to January 2019 as the research subjects, and divided them into a control group and experimental group by a random grouping method, with 120 cases in each group. The control group received conventional treatment, and the experimental group received blue phototherapy. We observed the therapeutic effect on the two groups and analyzed the onset factors, compared the transcutaneous bilirubin value, serum bilirubin level, the time for the jaundice to subside after treatment, lactate dehydrogenase (LDH), creatine kinase (CK) in the myocardial enzyme spectrum, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to show liver function.

Results: Rate of effective treatment in the experimental group was higher than that in the control group. The transcutaneous bilirubin values and serum bilirubin levels of the two groups of children with jaundice were reduced after treatment (P<0.001), and the decrease in the experimental group after treatment was more notable (P<0.001). Jaundice subsided after treatment in the experimental group faster than in the control group (P<0.001). Children with jaundice in the experimental group had lower indexes of LDH, CK, ALT and AST compared with those of the control group (P<0.05).

Conclusion: Phototherapy is a preferable method for neonatal jaundice and worthy of clinical application.

Keywords: Neonatal jaundice; blue phototherapy; clinical effect; etiology.

Figure 1

Comparison of serum total bilirubin levels and transcutaneous bilirubin index before and after treatment between the two groups. Note: A. The abscissa indicates before and after treatment, and the ordinate indicates the serum total bilirubin level (μmol/L). The serum total bilirubin levels of the control group before and after treatment were (265.68±34.26) μmol/L and (180.32±34.16) μmol/L, respectively. The serum total bilirubin levels before and after treatment in the experimental group were (271.36±26.00) μmol/L and (115.34±45.87) μmol/L. A significant difference in serum total bilirubin levels before and after treatment was seen in the control group (t=19.327, **P<0.01). The serum total bilirubin levels of jaundiced children in the experimental group were significantly different before and after treatment (t=32.414, **P<0.01). There was a significant difference in serum total bilirubin levels between the control group and the experimental group after treatment (t=12.446, **P<0.01). B. The abscissa represents before and after treatment, and the ordinate represents transcutaneous bilirubin index (mg/dl). The transcutaneous bilirubin index of the control group before and after treatment was (16.33±2.32) mg/dl and (10.87±2.09) mg/dl, respectively. The transcutaneous bilirubin index of the experimental group before and after treatment was (16.07±1.05) mg/dl, and (6.35±2.68) mg/dl. The transcutaneous bilirubin index of the control group was significantly different before and after treatment (t=19.154, **P<0.01). There was a significant difference in transcutaneous bilirubin index in the experimental group before and after treatment (t=36.992, **P<0.01). There was a significant difference in transcutaneous bilirubin index between the control group and the experimental group after treatment (t=17.202, **p<0.01).

Figure 2

Jaundice disappearance time after treatment in the two groups (d). Note: The abscissa represents the control group and the experimental group, and the ordinate represents the jaundice disappearance time after treatment (d). In the control group, the disappearance time of jaundice after treatment was (7.83±0.51) days. The disappearance time of jaundice in the experimental group after treatment was (6.73±0.45) days. There was a significant difference in disappearance time of jaundice between the control group and the experimental group after treatment (t=17.716, **P<0.01).

Figure 3

Comparison of myocardial enzyme spectrum indexes and liver function index levels after treatment (U/L). Note: A. The abscissa represents CK and LDH in the myocardial enzyme spectrum after treatment, and the ordinate represents the myocardial enzyme spectrum index (U/L). The CK and LDH of the jaundice children in the control group after treatment were (201.36±71.93) U/L and (401.36±111) U/L, respectively. The CK and LDH of children with jaundice in the experimental group after treatment were (176.39±59.3) U/L and (365.42±108.27) U/L, respectively. There was a significant difference in CK between the control group and the experimental group of children with jaundice after treatment (t=2.934, *P=0.0037). There was a significant difference in LDH between the control group and the experimental group of children with jaundice after treatment (t=2.539, *P=0.011). B. The abscissa represents ALT and AST after treatment, and the ordinate represents liver function indexes (U/L). The ALT and AST of children with jaundice in the control group after treatment were (45.68±15.55) U/L and (44.27±15.94) U/L, respectively. The ALT and AST of children with jaundice in the experimental group after treatment were (37.26±10.72) U/L and (36.84±13.14) U/L, respectively. There was a significant difference in ALT between the control group and the experimental group (t=4.888, **P<0.01). There was a significant difference in AST between the control group and the experimental group of children with jaundice after treatment (t=2.934, **P<0.01).