新生儿黄疸光疗时氧自由基对光疗致溶血的影响

A Study on the effect of oxygen free rodical to hemolysis in neonates with jaundice during phototherapy

目的探讨新生儿黄疸光疗时氧自由基变化对光疗致溶血的影响。方法将高胆光疗病人随机分为维生素E干预组和对照组,动态测定红细胞超氧化物歧化酶(R-SOD)、血浆总超氧化物歧化酶(T-SOD)、铜锌超氧化物歧化酶(CuZn-SOD)、丙二醛(MDA)、活性氧(ROS)、总胆红素(TB)、血红蛋白(HB)及光疗指数,与正常新生儿组测定值比较。结果各组30例,光疗前:干预组与对照组各项指标差异无显著性,P>0·05;干预组、对照组比正常组MDA高、R-SOD低,差异有显著性,P<0·01或0·05。HB三组无显著性差异。光疗时对照组R-SOD、HB降低,ROS、MDA增高,干预组R-SOD增高,ROS、MDA及HB降低;在光疗24、36、48h时,干预组比对照组,R-SOD、HB高,MDA、ROS低、光疗指数小,P<0·01或P<0·05。干预组和对照组光疗后HB均比光疗前低,差异有显著性,P<0·01。结论光疗时红细胞抗氧化能力进一步下降,氧自由基生成增多导致红细胞脂质过氧化损害加重、溶血加剧是光疗致溶血重要机制之一。维生素E干预可抗光疗时氧自由基损害、减轻溶血和缩小光疗指数。

Objective To study the effects of oxygen free radical（OFR） on the hemolysis in neonates with hyper - unconjugated bilimbmemia during phototherapy. Methods the neonates is randomly divided tnto the group treated with vitamine E and control group. The changes of R - SOD, T- SOD and CuZn - SOD activities and MDA, ROS, TB and HB the concentrations and the index of phototherapy of 0, 24, 36 and 48 hours during phototherapy were measured in the ones with phototherapy and normal one. They were compared with each other. Results There are 30 cases in each group pre - phototherapy： the levels of all were no significant difference between the treated group and the control one. Compared with the normal one, plasmtic MDA is higher, R - SOD is lower（P 〈 0.01 or 〈 50.05 ） significantly in both of the treated and the control. The levels of HB were no significant difference in the three groups. During phototherapy： the R - SOD, HB were lower, the ROS, MDA were higher in the control group. The R - SOD was higher, the ROS, MDA were lower in the treated group. Compared with the control group, of 24, 36, 48 hours after phototherapy, the R - SOD, HB were higher＇, MDA, ROS were lower and the indices of phototherapy were smaller m the group treated with vitamine E（P 〈 0.01 or 0.05 ） . Post - phototherapy , the levels of HB all were lower in the tow groups with phototherapy. Conclusion There are regularly the changes of OFR in the neonates with jaundice during phototherapy. There was a enhancing Lipid peroxidative damage to the RBC of the neonates. Phototherapy will enhance the lipid peroxidative and hemolysis to the neonates, the hemolysis is closely related to the lipid peroxidatlve, vitamine E powder preparaiont can alleviate the damage and hemolysis.