早期吸入一氧化氮能改善极早产儿的氧化平衡  

Early inhaled nitric oxide improves oxidative balance in very preterm infants

作　　者：Hamon I. Fresson J. Nicolas M.-B. 宁亮 

机构地区：[1]Reanimation Neonatale , Maternite Regionale Univ. de Nancy, 10 rue du Dr Heydenreich, 54 042 Nancy Ced ex, France Dr.

出　　处：《世界核心医学期刊文摘（儿科学分册）》2005年第10期60-61,共2页

摘　　要：Inhaled nitric oxide (iNO) improves oxygenation in premature infants, but conc ern has been raised about its potential oxidative toxicity. We designed this stu dy to assess the oxidative balance in premature infants who were exposed to low dose iNO and the relationship with their clinical outcome on day 28 of life. Ato tal of 274 infants who were < 32 wk gestation were randomized at birth to receiv e 5 ppm of iNO if they presented with hypoxemic respiratory failure. Nonhypoxemi c infants were studied as the reference group. Blood samples were withdrawn 24 h apart, within the first 4 d of life, to assess malondialdehyde (MDA)-concentra tion as oxidative stress marker and total plasmatic glutathione (GSH), intraeryt hrocyte GSH peroxidase, and GSH reductase activities as antioxidant defenses. Af ter 24 h, the rise in MDA was blunted in the iNO group compared with controls an d was close to the reference infants. Conversely, GSH was more stable in the iNO group, when there was no difference for the GSH peroxidase and GSH reductase ac tivities. On day 28, Oxygen dependence was linked with a higher increase in MDA as was the risk for death, whereas intraventricular hemorrhage was associated wi th a higher initial drop in GSH. Early low-dose iNO in hypoxemic preterm infant s improves oxidative balance and seems to be clinically beneficial up to day 28 of life.Inhaled nitric oxide (iNO) improves oxygenation in premature infants, but conc ern has been raised about its potential oxidative toxicity. We designed this stu dy to assess the oxidative balance in premature infants who were exposed to low dose iNO and the relationship with their clinical outcome on day 28 of life. Ato tal of 274 infants who were < 32 wk gestation were randomized at birth to receiv e 5 ppm of iNO if they presented with hypoxemic respiratory failure. Nonhypoxemi c infants were studied as the reference group. Blood samples were withdrawn 24 h apart, within the first 4 d of life, to assess malondialdehyde (MDA)-concentra tion as oxidative stress marker and total plasmatic glutathione (GSH), intraeryt hrocyte GSH peroxidase, and GSH reductase activities as antioxidant defenses. Af ter 24 h, the rise in MDA was blunted in the iNO group compared with controls an d was close to the reference infants. Conversely, GSH was more stable in the iNO group, when there was no difference for the GSH peroxidase and GSH reductase ac tivities. On day 28, Oxygen dependence was linked with a higher increase in MDA as was the risk for death, whereas intraventricular hemorrhage was associated wi th a higher initial drop in GSH. Early low-dose iNO in hypoxemic preterm infant s improves oxidative balance and seems to be clinically beneficial up to day 28 of life.

关 键 词：氧化应激 采集血样 还原酶活性 过氧化酶 出生后 低氧血症 呼吸困难 参照组 谷胱甘肽 

分 类 号：R722.6[医药卫生—儿科]