高胆红素血症新生儿血浆8-异-前列腺素F_(2α)水平与心肌酶谱和肝肾功能的相关性

Relationships of Plasma 8-Iso-Prostaglandin F_(2α) Level and Myocardial Enzyme,Hepatic Function and Renal Function in Newborn Infants with Hyperbilirubinemia

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.