Свободный билирубин как предиктор нейротоксичности: вопрос будущего?
DOI:
https://doi.org/10.15574/PP.2018.76.67Ключевые слова:
свободный билирубин, желтуха, менеджмент, новорожденный, окислительный стресс, фототерапияАннотация
Свободный билирубин является относительно новым маркером, который более информативен при оценке риска нейротоксичности билирубина. Этот маркер в будущем может быть полезным для менеджмента желтухи новорожденных, а также использоваться в качестве одного из критериев для операции заместительного переливания крови. Он представляет собой фракцию билирубина в сыворотке или плазме, которая не связана с белками и лучше проходит через гематоэнцефалический барьер. В ближайшем будущем вероятно изменятся взгляды на интерпретацию некоторых биохимических параметров, и для оценки риска нейротоксичности будет недостаточно использовать только показатель общего билирубина, особенно у недоношенных новорожденных. Самым большим препятствием для использования и введения этого маркера в клиническую практику является необходимость адаптации метода для повседневного использования. Результаты клинических исследований и накопленные данные позволяют предположить ускоренную интеграцию этого параметра в рутинный протокол менеджмента желтухи новорожденных.
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