Why should the neonatologist give a closer look at the alkaline phosphatase?

Q4 Medicine
Vlad Dima, R. Bohîlțea, Raluca Mariana Stanescu, Andreea Avramescu-Calomfirescu, V. Varlas, A. Davitoiu
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引用次数: 0

Abstract

Background. Alkaline phosphatase (ALP) has been intensively studied and proved to be useful in Neonatology. The first condition studied in correlation with increased ALP values was osteopenia of prematurity. In recent years there was an increase interested in correlations between ALP and bilirubin levels. In this article, we want to review the literature to find other benefits of ALP dosing in neonatal patients. Methods. Clinical trials were searched and analyzed by a single individual (via dedicated search engines such as Google Scholar, PubMed, and Scopus). We have included clinical studies from the last 7 years that present statistically significant results regarding the role of ALP dosing in the screening or diagnosis of other neonatal pathologies (jaundice with hyperbilirubinemia, necrotizing enterocolitis, liver dysfunction, renal failure and oncological diseases). Results. After excluding the clinical trials that did not meet the eligibility criteria, 6 clinical trials remained (n = 859). Following the analysis of these studies, correlations were highlighted between high ALP values in the umbilical cord and the need for phototherapy. It was also shown that all newborns with elevated ALP values required treatment for hyperbilirubinemia, as well as being a good predictor of severe jaundice and helping to predict its onset. Also, evidence about the correlation between high values of ALP and prematurity osteopenia was reaffirmed in recent studies. Conclusions. ALP is an easily dosed biomarker that can be successfully used in Neonatology. The existing studies to date encourage the use of ALP as a biomarker especially for the detection of osteopenia of prematurity and for the early detection of newborns who will develop intense forms of jaundice. There are still differences regarding the serum ALP values considered as cut-offs for the diagnosis of various neonatal conditions, but performing multicenter studies on a large number of cases could establish a valid consensus in order to use the same ALP cut-off values in all Neonatology departments.
为什么新生儿学家应该仔细观察碱性磷酸酶?
背景。碱性磷酸酶(ALP)已被广泛研究并被证明在新生儿学中是有用的。与ALP值升高相关的第一个研究条件是早产儿骨质减少。近年来,人们对ALP和胆红素水平之间的相关性越来越感兴趣。在这篇文章中,我们想回顾文献,以发现ALP给药在新生儿患者中的其他好处。方法。临床试验由单个人(通过谷歌Scholar、PubMed和Scopus等专用搜索引擎)进行搜索和分析。我们纳入了过去7年的临床研究,这些研究在ALP剂量在筛查或诊断其他新生儿病理(黄疸伴高胆红素血症、坏死性小肠结肠炎、肝功能障碍、肾功能衰竭和肿瘤疾病)中的作用方面显示了具有统计学意义的结果。结果。在排除不符合入选标准的临床试验后,还剩下6项临床试验(n = 859)。在对这些研究进行分析后,强调了脐带高ALP值与光疗需求之间的相关性。研究还表明,所有ALP值升高的新生儿都需要治疗高胆红素血症,同时也是严重黄疸的良好预测指标,有助于预测其发病。此外,最近的研究也证实了高ALP值与早产儿骨质减少之间的相关性。结论。ALP是一种易于计量的生物标志物,可以成功地用于新生儿。到目前为止,现有的研究鼓励使用ALP作为一种生物标志物,特别是用于检测早产儿骨质减少和早期检测将发展为强烈黄疸的新生儿。血清ALP值作为诊断各种新生儿疾病的截断值仍然存在差异,但对大量病例进行多中心研究可以建立有效的共识,以便在所有新生儿科使用相同的ALP截断值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.10
自引率
0.00%
发文量
15
审稿时长
4 weeks
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