不同模式光疗对高胆红素血症新生儿的影响  

Influence of different modalities of phototherapy for hyperbilirubinemia in neonates

作　　者：袁传顺[1] 陈吉庆[2] 陆超[2] 徐莉[1] 陈新跃[1] 杜娟[1] 张子前 

机构地区：[1]常州市第七人民医院儿科,213011 [2]南京医科大学第一附属医院儿科

出　　处：《江苏医药》2009年第8期884-886,共3页Jiangsu Medical Journal

基　　金：常州市卫生局指导性科技项目(WZ200743);江苏省卫生厅医学科技发展基金(K200504)

摘　　要：目的探讨不同光疗方式对新生儿高胆红素血症的疗效与副作用。方法将112例高胆红素血症新生儿随机分为间断光疗Ⅰ组、Ⅱ组及持续光疗组。观察治疗前后各组患儿退黄效果、出现的副反应及对外周血单核细胞中第二线粒体源半胱天冬氨酸蛋白酶激活物(Smac)-mRNA的影响。结果光疗后持续光疗组与间断光疗Ⅰ、Ⅱ组间血清总胆红素(TSB)水平比较差异均有统计学意义(P<0.01);持续光疗组副作用要明显高于间断光疗Ⅰ组、Ⅱ组(P<0.01),但各组患儿治疗前、后Smac-mRNA相对值的比较差异均无统计学意义。结论3种光疗模式治疗高胆红素血症均有效,且无严重的细胞毒性损伤。两种间断模式的光疗副作用明显少于持续光疗模式,更易为患儿家属所接受。持续光疗因其疗效显著可用于重症患儿。Objective To explore the efficacy and side effects of different modalities of phototherapy/or hyperbilirubinemia in neonates. Methods One hundred and twelve neonates with hyperbilirubinemia were randomly divided into three groups of interval phototherapy group Ⅰ （IP Ⅰ ） and Ⅱ （IPⅡ ） and persistent phototherapy group （PP）. The changes of total serum bilirubin（TSB） and side effects were observed. The expression of second mitochondria-derived activator of Caspase （Smae）-mRNA was detected using reverse transcription-PCR in peripheral blood monouclear cells （PBMC）. Results There were statistical differences in TSB levels between groups of IP Ⅰ and IP Ⅱ and group PP （P〈0. 01）. In terms of side effects, no significant difference was noted between group IP Ⅰ and group IP Ⅱ , but significant difference existed between group IP Ⅰ and group PP or between group IPⅡ and group PP （P〈0. 01）. There were no significant differences in the levels of Smac- mRNA among the three groups. Conclusion The three therapeutic modalities are all effective for hyperbilirubinemia without significant DNA damage. The interval phototherapy has less side effects than persistent phototherapy. But 72-hour persistent phototherapy is suitable in severe cases with hyperbilirubinemia.

关 键 词：高胆红素血症 光疗 新生儿 

分 类 号：R722[医药卫生—儿科]