复合辅酶联合维生素E对新生儿高胆红素血症肝肾损害的保护作用

Protective Effect of Coenzymes Complex Combined with Vitamin E on Liver and Kidney Injury Induced by Neonatal Hyperbilirubinemia

目的探讨早期联合应用复合辅酶及维生素E对新生儿高胆红素血症肝肾功能损害的干预效果。方法150例足月高胆红素血症新生儿作为观察组,据胆红素值分为轻、中、重3组,另选取同期出生的健康无黄疸或生理性黄疸的足月新生儿共45例作为对照组。入院24 h内检测血清γ-谷氨酰转移酶(γ-GGT)、总胆红素及胱抑素C(Cys-C)、丙二醛(MDA)等指标。另将观察组随机分为常规组和联合组。联合组早期给予复合辅酶、维生素E以及常规治疗,常规组仅给予常规干预,治疗1周复查以上指标。结果治疗前轻、中、重度组MDA均较对照组增高(P<0.05),而γ-GGT及Cys-C仅在中、重度组较对照组升高(P<0.05),且总胆红素与MDA、γ-GGT及Cys-C水平间呈正相关(P<0.05),MDA与Cys-C、γ-GGT间亦呈正相关(P<0.01)。经早期干预治疗后,随着胆红素下降,血γ-GGT及Cys-C、MDA等亦有所降低,其中联合组较常规组降低更显著(P<0.05)。结论高胆红素血症时,可能通过胆红素诱导的脂质过氧化作用对新生儿肝肾造成损害,在常规治疗基础上加用复合辅酶及维生素E有一定的保护作用。

Objective To study the effect of coenzymes complex combined with vitamin E on liver and kidney inju-ry induced by neonatal hyperbilirubinemia. Methods One hundred and fifty full-term neonatals with hyperbilirubinemia were chosen as observation groups, who were divided into mild, moderate and severe groups according bilirubin. Forty five healthy full-term newborns in the same period, who are either healthy or with physiological jaundice, were selected as con-trol group. Serum total bilirubin, gamma-glutamyl transferase （γ-GGT） , Malondialdehyde （MDA） and Cys-C were measured within 24 hours of hospital admission.The observation groups were randomly divided into regular and combined treatment groups. Coenzymes complex combined with vitamin E were given in addition to regular method to combined group while reg-ular group only received regular methods.All above biochemical indexes were tested in the 7th day after medication admin-istration. Results Serum MDA were higher in all observation groups （mild, moderate and severe groups） than in control group （P〈0.05）;but the levels ofγ-GGT and Cys-C increased in moderate and severe groups compared with control group （P〈0.05）. There were positive correlations （P〈0.05） between levels of serum total bilirubin with MDA,γ-GGT and Cys-C. Positive linear correlation were found between MDA with γ-GGT and Cys-C（P〈0.01）. After early intervention,γ-GGT, Cys-C and MDA declined with drop of bilirubin level. This is more prominent and faster in a in combined treatment group than regular group （P〈0.05）.Conclusion In hyperbilirubinemia newborns, lipid peroxidation activated by bilirubin may lead to damages of liver and kidney. Coenzymes combined with vitamin E have protective effect to these damages.