Sinha S, Davies J, Toner N, Bogle S, Chiswick M
Lancet. 1987 Feb 28;1(8531):466-71. doi: 10.1016/s0140-6736(87)92087-3.
231 babies, born at less than or equal to 32 weeks' gestation were enrolled in a randomised, controlled trial to assess the efficacy of vitamin E (dl-alpha-tocopherol acetate) in the prevention of periventricular haemorrhage. Daily supplementation with 20 mg/kg vitamin E intramuscularly during the first 3 days of life was associated with a rise in plasma vitamin E concentration and a reduction in hydrogen peroxide haemolysis of red blood cells in vitro. Among babies without haemorrhage on entry to the trial (n = 210), supplemented babies had a lower frequency of intraventricular haemorrhage than controls (8.8% v 34.3%; p less than 0.005) and a lower combined frequency of intraventricular and parenchymal haemorrhage (10.8% v 40.7%; p less than 0.0001) on the final ultrasound brain scan. This protective effect was observed in both inborn and referred babies but was stronger in the former. Supplementation had no effect on mortality, but among survivors fewer supplemented babies than controls had intraventricular or parenchymal haemorrhage (10.7% v 32.6%; p less than 0.001). Possibly, vitamin E scavenges free radicals generated during ischaemic injury of the subependymal region and thereby limits tissue damage and the extent of periventricular haemorrhage on reperfusion.
231名孕周小于或等于32周的婴儿被纳入一项随机对照试验，以评估维生素E（dl-α-生育酚醋酸酯）预防脑室周围出血的疗效。在出生后的头3天内，每天肌肉注射20mg/kg维生素E，可使血浆维生素E浓度升高，并降低体外红细胞的过氧化氢溶血率。在试验开始时无出血的婴儿（n = 210）中，补充维生素E的婴儿脑室内出血的发生率低于对照组（8.8%对34.3%；p<0.005），在最终的脑部超声扫描中，脑室内和脑实质出血的合并发生率也较低（10.8%对40.7%；p<0.0001）。这种保护作用在足月儿和转入的婴儿中均有观察到，但在前者中更强。补充维生素E对死亡率没有影响，但在幸存者中，补充维生素E的婴儿发生脑室内或脑实质出血的比例低于对照组（10.7%对32.6%；p<0.001）。维生素E可能清除了室管膜下区域缺血性损伤期间产生的自由基，从而限制了组织损伤和再灌注时脑室周围出血的范围。
