Merrikhi A R, Ghaemi S, Gheissari A, Shokrani M, Madihi Y, Mousavinasab F
Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Isfahan, Iran.
J Pak Med Assoc. 2012 Mar;62(3 Suppl 2):S48-51.
Considering the relation between prematurity andasphyxia and also renal failure in neonates, the aim of this study was to determine the effect of aminophyllinein urine and serum indices of renal failure and consequently its prevention, in Premature Infants with asphyxia in Esfahan-lran.
In this descriptive clinical trial study, 22 preterm neonates diagnosed with perinatal asphyxia in neonatal ward of Shahid Beheshti hospital, during 2009.The participants were randomized in two intervention and placebo groups. They randomized to receive a single dose of aminophyiline (5 mg/kg) or placebo of 5% dextrose water for injection (5 cc/kg) during the first hour of life. Renal function was assessed by GFR, beta2-microglobulin (beta2M), N-acetyl-glucosaminidase (NAG) serum creatinine and electrolytes level measurement, during the 1st, 4th and 7th day of life, in two studied groups. The results compare between the two groups before and after intervention.
Mean of urine output, was significantly higher in neonates who received aminophylline (P < 0.05).Mean of 132M and NAG 24 hours after intervention was not significant in the two groups of asphyxiated preterm neonates (P > 0.05).GFR was significantly higher in neonates who received aminophylline on 4th day of life (P < 0.05) and it had trend to be significantly high on 7th day (P = 0.05) and was not significantly high on 1st day (P > 0.05) comparing with control group. The most common pathophysiology of renal failure was prerenal.
Aminophylline could prevent renal dysfunction in preterm neonates with asphyxia. Neonates who received aminophylin on the first day of life indicated a significant improvement in GFR and urine output.
鉴于早产、窒息与新生儿肾衰竭之间的关系，本研究旨在确定氨茶碱对伊朗伊斯法罕窒息早产儿肾衰竭尿液和血清指标的影响，并由此预防肾衰竭。
在这项描述性临床试验研究中，2009年期间，在沙希德·贝赫什提医院新生儿病房对22例诊断为围产期窒息的早产儿进行了研究。参与者被随机分为干预组和安慰剂组。他们在出生后第一小时被随机分配接受单剂量氨茶碱（5mg/kg）或5%葡萄糖注射液安慰剂（5cc/kg）。在出生后的第1、4和7天，通过测量肾小球滤过率（GFR）、β2-微球蛋白（β2M）、N-乙酰氨基葡萄糖苷酶（NAG）、血清肌酐和电解质水平来评估两组研究对象的肾功能。对两组干预前后的结果进行比较。
接受氨茶碱治疗的新生儿尿量均值显著更高（P<0.05）。两组窒息早产儿干预后24小时的β2M和NAG均值无显著差异（P>0.05）。与对照组相比，出生后第4天接受氨茶碱治疗的新生儿GFR显著更高（P<0.05），第7天有显著升高的趋势（P=0.05），第1天无显著升高（P>0.05）。肾衰竭最常见的病理生理机制是肾前性。
氨茶碱可预防窒息早产儿的肾功能障碍。出生第一天接受氨茶碱治疗的新生儿GFR和尿量有显著改善。
