Hamidi Majid, Zamanzad Behnam, Mesripour Azadeh
Department of Pediatrics, Shahrekord University of Medical Sciences, Iran.
Department of Microbiology, Shahrekord University of Medical Sciences, Iran.
EXCLI J. 2013 Jan 22;12:75-8. eCollection 2013.
The aim of treating hyperbilirubinemia is preventing the serum bilirubin to reach neurotoxic levels, which is done by phototherapy or blood transfusion. However, pharmacological treatments still remain vague. Therefore the effects of adding either clofibrate or phenobarbital on treatment outcomes was evaluated in icteric non-hemolitic newborns. Ninety neonates were divided in three groups. Two groups were prescribed 100 mg/kg clofibrate or 5 mg/kg phenobarbital orally as single dose on arrival, in addition to phototherapy. The control group only received phototherapy. Serum bilirubin was evaluated at the reception and 12, 24, 48 and 72 hours after beginning of drug therapy. Total bilirubin levels decreased in treated groups compared with the control group in all samples taken (12, 24, 48 and 72 hours). Clofibrate effect in decreasing bilirubin level was more prominent (14 % and 32 % after 12 and 72 h respectively). In addition duration of hospitalization and length of phototherapy decreased in clofibrate and phenobarbital groups compared with control group (1.5, 2 days respectively, vs. 2.6 days). Therefore using clofibrate and phenobarbital in icteric neonates are supportive not only by decreasing the serum bilirubin level, but also by lessening the duration of hospitalization and phototherapy. Thus in addition to cost benefits for the patient these drugs can reduce the risks of transfusion, and clofibrate seems more promising in this regard.
治疗高胆红素血症的目的是防止血清胆红素达到神经毒性水平,这可通过光疗或输血来实现。然而,药物治疗仍然不明确。因此,在黄疸非溶血性新生儿中评估了添加氯贝丁酯或苯巴比妥对治疗结果的影响。90名新生儿被分为三组。两组在入院时除光疗外,还口服单剂量100mg/kg氯贝丁酯或5mg/kg苯巴比妥。对照组仅接受光疗。在接受治疗时以及药物治疗开始后的12、24、48和72小时评估血清胆红素。在所有采集的样本(12、24、48和72小时)中,治疗组的总胆红素水平与对照组相比有所下降。氯贝丁酯降低胆红素水平的效果更显著(分别在12小时和72小时后降低14%和32%)。此外,与对照组相比,氯贝丁酯组和苯巴比妥组的住院时间和光疗时间缩短(分别为1.5天、2天,而对照组为2.6天)。因此,在黄疸新生儿中使用氯贝丁酯和苯巴比妥不仅有助于降低血清胆红素水平,还能缩短住院时间和光疗时间。因此,除了为患者带来成本效益外,这些药物还可以降低输血风险,在这方面氯贝丁酯似乎更有前景。