还原型谷胱甘肽预防极低出生体重儿胃肠外营养相关性胆汁淤积  

Effects of atuomolan (GSH) treatment on very low birth weight infant with parenteral nutrition associated homeostasis

作　　者：祝华平[1] 夏世文[1] 

机构地区：[1]湖北省妇幼保健院新生儿科,武汉430070

出　　处：《中国新生儿科杂志》2010年第5期275-277,共3页Chinese Journal of Neonatology

基　　金：湖北省研究与开发计划项目(2009BCC013)

摘　　要：目的探讨还原型谷胱甘肽(GSH)预防极低出生体重儿(VLBWI)胃肠外营养相关胆汁淤积(PNAC)的疗效及其作用机制。方法 2005年6月至2009年6月在本院应用胃肠外营养的VLBWI,随机分为对照组和观察组,观察组入院即开始应用GSH(阿拓莫兰)0.2g/d连用7d。两组患儿在日龄2d及21d时分别检测肝功能、血浆丙二醛(MDA)和GSH含量,对应用胃肠外营养14d以上者进行分析。结果对照组98例,发生胆汁淤积41例(41.8%),观察组110例,发生胆汁淤积28例(25.5%),两组差异有统计学意义(P<0.05)。对照组住院时间(49.1±18.3)d,血浆MDA值(31.4±2.5)nmol/L,GSH含量(56.2±3.8)mg/L,DBil(32.7±4.1)μmol/L,TBA(64.2±10.6)μmol/L。观察组住院时间(38.5±12.9)d,血浆MDA值(22.3±4.1)nmol/L,GSH含量(96.5±6.7)mg/L,DBil(18.3±5.2)μmol/L,TBA(32.1±6.9)μmol/L,两组差异均有统计学意义(P<0.05)。结论 GSH可显著降低VLBWIPNAC的发生率,减少住院天数,未观察到药物不良反应。其作用机制可能通过减少体内脂质过氧化提高机体抗氧化防御系统功能。Objective To ensure possible relationship between parenteral nutrition and hepatic cholestasis in VLBWI. To analyze the effects and mechanism of atuomolan （glutathione,GSH） prevention and treatment on parenteral nutrition associated cholestasis （PNAC）. Methods VLBW newborns with more than 14 days parenteral nutrition from June 2005 to June 2009 in the hospital were divided into two groups randomly,control group and Observing group. Observing group injected 0.2 g atuomolan （GSH） through venous every day for 7 days at admission. Clinical symptoms were observed,Liver function,GSH and MDA concentration in serum were measured by biochemistry method at postnatal day 2 and day 21,respectively. VLBW newborns with more than 14 days parenteral nutrition were analysed. Results There were 41 cases developed PNAC in control group （41.8%） and 28 cases in observing group （25.5%）. There were significant difference between two groups （P0.05）. In control group,hospitalization time was （49.1±18.3） d. Blood MDA concentration was （31.4±2.5） nmol/L,blood GSH concentration was （56.2±3.8） mg/L,Dbil was （32.7±4.1） μmol/L,TBA was （64.2±10.6） μmol/L. In observing group,hospitalization time was（38.5±12.9） d. Blood MDA concentration was （22.3±4.1） nmol/L,blood GSH concentration was （96.5±6.7） mg/L,Dbil was （18.3±5.2） μmol/L,TBA was （32.1±6.9） μmol/L. There were significant difference between two groups （P0.05）. Conclusion GSH can lower the incidence of PNAC and decrease hospitalization time in very low birth weigh infant.No adverse effects were observed. Its mechanism is related with that GSH decrease lipid peroxidation damage and enhance the function of anti-oxygen defense system.

关 键 词：谷胱甘肽 婴儿 极低出生体重 胃肠外营养 胆汁淤积 

分 类 号：R722[医药卫生—儿科]