Ozkan H, Uzuner N, Oren H, Cabuk N, Işlekel H
Departments of Neonatology, Pediatric Hematology, and Biochemistry, Dokuz Eylül University, Medical School, Izmir, Turkey.
Biol Neonate. 2000 Feb;77(2):101-4. doi: 10.1159/000014202.
To investigate the correlation between the prophylactic administration of intravenous immunoglobulin (IVIG) to preterm infants and urinary nitrite levels, which can be utilized as an index of endogenous nitric oxide (NO) formation, and to determine if NO formation plays a role in both therapeutic and adverse effects of IVIG.
28 healthy preterm infants were included in this prospective study. They had a mean gestational age of 29.4 +/- 2.2 weeks and weight of 1,387 +/- 371 g. Prophylactic IVIG infusion at a dose of 0.5 g/kg/day was administered when they were 3-10 days old. Urine samples of the neonates were obtained for analysis on days 1, 2 and 3 after IVIG administration as well as 1 day before. Urinary nitrite levels obtained in the subjects were normalized for urinary creatinine concentrations.
The mean urinary nitrite levels were: 2.77 +/- 1.66 micromol/mmol creatinine before IVIG administration; 4.33 +/- 3.88 micromol/mmol creatinine on the 1st day of IVIG; 3.77 +/- 2.73 micromol/mmol creatinine on the 2nd day, and 3.64 +/- 3.28 micromol/mmol creatinine on the 3rd day. There was a significant increase in urinary nitrite levels between before and after IVIG administration. There was no statistical difference in urinary nitrate levels between days 1, 2 and 3 after IVIG administration.
We demonstrated that urinary nitrite excretion is significantly elevated in preterm infants after prophylactic IVIG administration and this result suggests that endogenous NO formation may play an important role in both the therapeutic and adverse effects of IVIG.
研究对早产儿预防性静脉注射免疫球蛋白（IVIG）与尿亚硝酸盐水平之间的相关性，尿亚硝酸盐水平可作为内源性一氧化氮（NO）生成的指标，并确定NO生成在IVIG的治疗作用和不良反应中是否起作用。
本前瞻性研究纳入了28名健康早产儿。他们的平均胎龄为29.4±2.2周，体重为1387±371克。在他们3至10日龄时，以0.5克/千克/天的剂量进行预防性IVIG输注。在IVIG给药后的第1、2和3天以及给药前1天采集新生儿的尿液样本进行分析。将受试者的尿亚硝酸盐水平根据尿肌酐浓度进行标准化。
IVIG给药前尿亚硝酸盐平均水平为：2.77±1.66微摩尔/毫摩尔肌酐；IVIG给药第1天为4.33±3.88微摩尔/毫摩尔肌酐；第2天为3.77±2.73微摩尔/毫摩尔肌酐；第3天为3.64±3.28微摩尔/毫摩尔肌酐。IVIG给药前后尿亚硝酸盐水平有显著升高。IVIG给药后第1、2和3天的尿硝酸盐水平无统计学差异。
我们证明，预防性IVIG给药后早产儿的尿亚硝酸盐排泄显著升高，这一结果表明内源性NO生成可能在IVIG的治疗作用和不良反应中起重要作用。
