光疗对早产儿血内皮素及一氧化氮水平的影响及临床意义  

Effect of phototherapy on blood endothelin and nitric oxide levels in preterm infants

作　　者：柳国胜[1] 吴慧 吴本清 黄润忠 赵立华[1] 文妍[1] 

机构地区：[1]暨南大学附属第一医院儿科,广东广州510632 [2]番禺何贤纪念医院,广东广州511400 [3]暨南大学第二临床医学院附属深圳市人民医院儿科,广东深圳518020 [4]佛山市顺德区妇幼保健院,广东佛山528300

出　　处：《中国小儿急救医学》2006年第5期423-425,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的观察光疗对早产儿血内皮素(ET)和一氧化氮(NO)水平的影响。方法以64例符合光疗条件的高未结合胆红素血症早产儿为研究对象,其中胎龄>32周组31例,胎龄≤32周组33例,并以26例符合光疗条件的高未结合胆红素血症足月儿为对照组,给予24 h连续光疗。用放射免疫法测定ET,用硝酸还原酶法测定NO。在光疗期间定期监测心率、呼吸(包括呼吸暂停)、平均动脉压。结果胎龄≤32周组:光疗24 h与光疗前比较血浆ET值明显升高(P<0.05);光疗12和24 h较光疗前血清NO值升高具有统计学意义(P<0.05);光疗24 h与光疗前血NO/ET比值的升高也具有统计学意义(P<0.05)。胎龄>32周组:仅光疗24 h较光疗前血清NO值升高有统计学意义(P<0.05)。胎龄≤32周组光疗24 h较光疗前心率增快、平均动脉压下降均有统计学意义(P<0.05),光疗24 h血NO/ET比值与平均动脉压呈负相关性。胎龄≤32周组较胎龄>32周组和足月组光疗中呼吸暂停发生例次数明显增多。结论光疗对早产儿尤其小胎龄早产儿血ET、NO影响明显,可能会导致血流动力学改变,应予关注。Objective To observe the effect of phototherapy on blood endothelin （ET） and nitric oxide （NO） levels in preterm infants. Methods A total of 64 preterm infants with hyperbilirubinemia requiring phototherapy were included in the study. Among them, 31 patients born at 32-36 weeks of gestation age（GA） and 33 patients born at 32 weeks. The control group included 26 full term infants with hyperbilirubinemia requiring phototherapy. All patients were treated with continuous phototherapy for 24 hours. Blood samples were collected before and after 12,24 h of phototherapy. The lever of ET in the blood samples was determined by radioimmuno-assay, and NO level was determined using nitrate reductase. Heart rate, respiratory rate, incidence of apnea, mean arterial blood pressure （MAP） were monitored regularly during phototherapy. Results （1） Blood ET level measured after 24 h of phototherapy was higher than the pretreatment value, as were blood NO levels measured after 12 h and 24 h of phototherapy. Both increases were statistically significant （P 〈 0.05 ） in the GA≤32 weeks group. （2）In the GA〉32 weeks group, blood NO level measured after 24 h phototherapy was significantly higher than the pretreatment value （P 〈 0.05）. （3）In the GA≤32 weeks group, heart rate increased and the MAP decreased during phototherapy. The changes following 24 h of phototherapy compared to pretreatment values were statistically significant. More episodes of apnea occurred during phototherapy in the GA≤32 weeks group. Conclusion Under phototherapy, blood levels of ET and NO are significantly higher in preterm infants, especially in preterim infant with GA≤32 weeks.

关 键 词：高胆红素血症 光疗 内皮素 一氧化氮 

分 类 号：R722.6[医药卫生—儿科]