摘要
目的探讨高胆红素血症(高胆)新生儿血浆8-异-前列腺素F2α(8-iso-PGF2α)水平和心肌酶谱、肝肾功能变化及其相关性。方法选择日龄2~7d的足月新生儿126例。其中高胆新生儿76例,依据总胆红素水平分为高胆甲组51例(总胆红素205~341μmol/L),高胆乙组25例(总胆红素≥342μmol/L);生理性黄疸50例为对照组(总胆红素<205μmol/L);应用酶免疫分析法测定各组新生儿血浆8-iso-PGF2α水平;应用常规生化方法检测各组新生儿血清AST、LDH、CK、CK-MB、ALT、清蛋白(ALB)、碱性磷酸酶(ALP)、血肌酐(Cr)、尿素氮(BUN);应用放射免疫分析法检测各组尿β2微球蛋白(β2-MG)。结果1.血清ALT、AST、LDH、CK和CK-MB水平随黄疸加重而升高,血清BUN、Cr和尿β2-MG水平随黄疸加重而升高。2.对照组新生儿血浆8-iso-PGF2α水平为(13.84±6.13)ng/L,95%CI为10.88~18.02ng/L;高胆甲组血浆8-iso-PGF2α水平为(19.56±2.74)ng/L,乙组血浆8-iso-PGF2α水平为(22.30±6.33)ng/L,与对照组血浆8-iso-PGF2α水平比较均有显著差异(Pa<0.05)。3.血清CK、CK-MB、ALT、ALP、BUN、Cr和尿β2-MG水平与血浆8-iso-PGF2α水平呈正相关(Pa<0.05)。结论高胆可引起新生儿心、肝、肾等脂质过氧化作用,使得心肌、肝肾功能受损;血浆8-iso-PGF2α水平是反映机体脂质过氧化损伤的可靠的生化指标之一;加用抗氧化剂治疗新生儿高胆红素血症将有利于病情的恢复。
Objective To explore the changes of myocardial enzymes, hepatic function, renal function and 8 - iso - prostaglandin F2α ( 8- iso-PGF2α ) in newborn infants with hyperbilirubinemia and their relationships. Methods One hundred and twenty - six neonates who were 2 to 7 days old were selected. Seventysix cases were hyperbilirubinemia,and according total bilirubin(TB) ,they were divided into hyper bilirubinemia A group( HBE - A) (51 cases ,TB 205 -341 μmol/L) and hyperbilirubinemia B group( HBE - B ) (25 cases ,TB ≥342 μmol/L). Fifty newborn infants with physiologic jaundice were control group( TB 〈 205 μmol/L). The serum aspartate aminotransferase (AST), lactate dehydrogenase ( LDH ), creatine kinase (CK), MB isoenzyme of creatine kinase ( CK - MB ), alanine aminotransferase ( ALT), human albumin (ALB), alkaline phosphatase( ALP), blood urine nitrogen(BUN) and serum creatine (C r) contents were measured by automatic biochemical analyzer. Urine β2 -microglobulin( 132 -MG)contents was detected by radio immunoassay. The level of 8 -iso -PGF2α in blood plasma was measured by enzyme immunoassay. Results 1. Serum ALT, AST, LDH, CK and CK - MB levels increased with the aggravation of jaundice; serum BUN, Cr and β2 - MG levels increased with the aggravation of jaundice. 2. Plasma 8 - iso - PGF2α level in control group was( 13. 84 ± 6.13) ng/L,95% confidence interval was 10.88 - 18.02 ng/L. Serum 8 - iso - PGF2α levels in HBE - A group was( 19.56 ± 2.74) ng/L, and in HBE - B group was (22.30 ±6.33 ) ng/L,there was obvious differences between HBE - A group, HBE - B group and control group ( Pa 〈 0. 05 ). 3. There was significantl correlation of serum BUN, ALP, CK - MB with plasma 8 - iso - PGF2α. In addition, positive correlations also existed between serum CK, CK - MB, ALT, ALP, BUN, Cr, and urine β2 - MG and plasma 8 - iso - PGF2α ( P 〈 0.05 ). Conclusions Hyperbilirubinemia can induce peroxidation damage,including the impairment of myoeardium, hepatic and renal functions. Plasma 8 - iso - PGF2α content increased in the neonates with hyperbilirubinemia. The determination of plasma 8 - iso - PGF2α level may accurately evaluate the bilirubin - induced peroxidation, suggesting the antioxidants should be added to treat neonatal hyperbilirubinemia.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第2期121-123,共3页
Journal of Applied Clinical Pediatrics
基金
江门市科技发展计划课题(江科[2007]17号)