Neonatal Services Division, Department of Pediatrics, Pt BD Sharma PGIMS, Rohtak, India. g
Indian Pediatr. 2011 Aug;48(8):613-7. doi: 10.1007/s13312-011-0106-x. Epub 2010 Nov 30.
To evaluate the effect of high dose phenobarbital on lipid peroxidation and antioxidant enzymes in perinatal asphyxia.
Open label, Randomized controlled trial.
Neonatal intensive care unit of a tertiary care teaching hospital.
72 full term inborn neonates with severe birth asphyxia.
Neonates were randomized to Study (phenobarbital) group and Control group. The infants in the study group received phenobarbital infusion (40 mg/kg) within first two hours of life while babies in the control group did not receive any phenobarbital. Rest of the management in both the groups was as per the unit protocol for the management of hypoxic ischemic encephalopathy. A cerebrospinal fluid examination was done at 12 ± 2 hours of life to determine the levels of superoxide dismutase, glutathione peroxidise and malonyldialdehyde. 60 neonates were followed up at 1 month of age when a detailed neurological examination was done.
Four neonates in the study group and six neonates in the control group died during the study. Two neonates in the study group were lost to follow up. The cerebrospinal fluid lipid peroxides and antioxidant enzymes were significantly lower in the phenobarbital group as compared to the control group. The neurological outcome at one month follow up was found to be comparable between the two groups.
Phenobarbital (40 mg/kg) given in the first two hours of life in term neonates with perinatal asphyxia led to a decrease in CSF levels of lipid peroxides and antioxidant enzymes at 12 ± 2 hours of life.
评估大剂量苯巴比妥对围产期窒息脂质过氧化和抗氧化酶的影响。
开放标签、随机对照试验。
三级教学医院新生儿重症监护病房。
72 例足月、严重出生窒息的先天新生儿。
新生儿随机分为研究（苯巴比妥）组和对照组。研究组婴儿在生命的头 2 小时内接受苯巴比妥输注（40mg/kg），而对照组婴儿未接受任何苯巴比妥。两组的其余治疗均根据缺氧缺血性脑病的治疗单元方案进行。在生命的 12±2 小时进行脑脊液检查以确定超氧化物歧化酶、谷胱甘肽过氧化物酶和丙二醛的水平。60 名新生儿在 1 个月大时接受随访，进行详细的神经检查。
研究组中有 4 名新生儿和对照组中有 6 名新生儿在研究期间死亡。研究组中有 2 名新生儿失访。与对照组相比，苯巴比妥组脑脊液脂质过氧化物和抗氧化酶明显降低。在 1 个月的随访时，两组的神经结局发现无差异。
在围产期窒息的足月新生儿生命的头 2 小时内给予苯巴比妥（40mg/kg）可导致 12±2 小时时脑脊液中脂质过氧化物和抗氧化酶水平降低。
