不同G-6-PD活性新生儿光疗致溶血机制及其预防

目的探讨不同G6PD活性新生儿光疗溶血机制及预防。方法将G6PD正常与缺陷光疗患儿随机分为维生素E干预组和对照组,测定比较超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧(ROS)、总胆红素(TB)、血红蛋白(Hb)及光疗指数。结果光疗前G6PD缺陷组比正常组SOD和Hb低,ROS高;光疗中G6PD缺陷干预组比正常干预组SOD高,MDA低,光疗指数小,G6PD缺陷对照组比正常对照组ROS、MDA高,光疗指数大(各组比较均P<0.01或P<0.05)。光疗后G6PD缺陷对照组Hb下降,并比干预组低,G6PD正常两组Hb均下降,干预组比对照组高(各组比较均P<0.01或P<0.05)。结论光疗可致抗氧化能力下降,脂质过氧化损伤致G6PD缺陷光疗者溶血更突出,维生素E干预更有效。

Mechanism and prevention of hemolysis of jaundiced infants with and without G-6-PD deficiency in phototherapy

Objective To study the mechanism and prevention of the hemolysis induced by phototherapy in neonate with and without G-6-PD deficiency.Methods The neonates who received phototherapy with and without G-6-PD deficiency were randomly divided into the group treated with vitamine E and control group.Plasma superoxide dismutase(SOD),malondialdehyde(MDA),reactive oxygen species(ROS),total bilirubin(TB) and hemoglobin(Hb) concentrations and the indexes of phototherapy were measured and compared.Results Before phototherapy,SOD and Hb was lower,ROS was higher in the G-6-PD deficiency than in the normal G-6-PD.During phototherapy,SOD was higher,MDA was lower,the indexes of phototherapy were lower in the treated group with G-6-PD deficiency than in the treated group with normal G-6-PD.In the control group with G-6-PD deficiency,ROS,MDA was higher, the indexes of phototherapy was higher than that in the control growp with normal G-6-PD.(P<0.01 or P<0.05).After phototherapy,in the control group with G-6-PD deficiency, Hb decreased and was lower than in the treated ones.Hb was lower in both groups of G-6-PD normal than those before phototherapy, but was higher in the treated than in the control (P<0.01 or P<0.05).Conclusion The ability of antioxidation decreases in phototherapy,lipid peroxidative damage is more important part in the hemolysis of neonate with G-6-PD deficiency in phototherapy,Vitamine E can effectively alleviate the hemolysis.