白蛋白输注疗法对接受强化光疗的足月儿总胆红素及游离胆红素值的影响。

Effects of albumin infusion therapy on total and unbound bilirubin values in term infants with intensive phototherapy.

作者信息

Hosono S, Ohno T, Kimoto H, Nagoshi R, Shimizu M, Nozawa M

机构信息

Division of Neonatology, Saitama Children's Medical Center, Japan.

出版信息

Pediatr Int. 2001 Feb;43(1):8-11. doi: 10.1046/j.1442-200x.2001.01338.x.

DOI:10.1046/j.1442-200x.2001.01338.x

PMID:11207991

Abstract

BACKGROUND

The purpose of the present study was to evaluate the effect of intravenous albumin administration on the serum total and unbound bilirubin values in term non-hemolytic hyperbilirubinemic neonates during intensive phototherapy.

METHODS

Fifty-eight infants (gestational age 39.4 +/- 1.4 weeks; birth weight 3,245 +/- 435 g) were given phototherapy with similar light energy. Twenty infants (control group) received only phototherapy, while 38 others (albumin-treated group) were also given human albumin at 1 g/kg bodyweight, i.v., during the first 2 h of phototherapy.

RESULTS

When comparing changes in total and unbound bilirubin values 0, 2, 6 and 24 h after entering the study between the albumin-treated group and the control group, there was a significant reduction in the serum unbound bilirubin values at the end of albumin treatment and at 6 and 24 h. However, there was no significant reduction in total serum bilirubin values during the study period. In the albumin-treated group, the mean serum unbound bilirubin reduction from the baseline level at the end of albumin treatment and at 6 and 24 h was 0.40 +/- 0.19, 0.41 +/- 0.20 and 0.43 +/- 0.20 microg/dL, respectively.

CONCLUSIONS

The results suggest that albumin priming may be effective for an immediate reduction in serum unbound bilirubin values, the fraction that is potentially neurotoxic.

摘要

背景

本研究的目的是评估静脉输注白蛋白对足月非溶血性高胆红素血症新生儿在强化光疗期间血清总胆红素和非结合胆红素值的影响。

方法

58名婴儿（胎龄39.4±1.4周；出生体重3245±435克）接受了相似光能的光疗。20名婴儿（对照组）仅接受光疗，而另外38名婴儿（白蛋白治疗组）在光疗的前2小时还接受了1克/千克体重的人白蛋白静脉输注。

结果

比较白蛋白治疗组和对照组在进入研究后0、2、6和24小时总胆红素和非结合胆红素值的变化，在白蛋白治疗结束时以及6和24小时，血清非结合胆红素值有显著降低。然而，在研究期间血清总胆红素值没有显著降低。在白蛋白治疗组中，白蛋白治疗结束时以及6和24小时，血清非结合胆红素从基线水平的平均降低值分别为0.40±0.19、0.41±0.20和0.43±0.20微克/分升。