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两种不同剂量熊去氧胆酸对接受光疗的葡萄糖-6-磷酸脱氢酶缺乏新生儿间接高胆红素血症的影响:一项随机对照试验

Effects of Two Different Doses of Ursodeoxycholic Acid on Indirect Hyperbilirubinemia in Neonates with Glucose-6-phosphate Dehydrogenase Deficiency Treated with Phototherapy: A Randomized Controlled Trial.

作者信息

Farhadi Roya, Keyhanian Elham, Naderisorki Mohammad, Nadi Ghara Aliasghar

机构信息

Pediatric Infectious Diseases Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Glob Pediatr Health. 2023 Feb 17;10:2333794X231156055. doi: 10.1177/2333794X231156055. eCollection 2023.

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the causes of severe hyperbilirubinemia, prolonged jaundice, and bilirubin-induced encephalopathy in neonates. In a randomized controlled trial, we evaluated the effect of oral ursodeoxycholic acid (UDCA) on indirect hyperbilirubinemia in G6PD-deficient neonates requiring phototherapy. Intervention group I (N = 45; received phototherapy and 10 mg/kg/day UDCA), Intervention group II (N = 40; received phototherapy and 20 mg/kg/day UDCA), and a control group (N = 49; received phototherapy and placebo). Levels of total serum bilirubin (TSB) in all 3 groups decreased significantly over time ( = .001) but the level of TSB at different hours after admission and the duration of phototherapy did not differ significantly between the 3 groups. After discharge, the 2 intervention groups had a significantly lower rate of readmission than the control group ( = .001). No significant difference was observed between the 10 and 20 mg/kg/day groups. Further evaluation is recommended, especially in terms of the pharmacokinetics of UDCA in neonates. IRCT20091201002801N4, prospectively registered on 2019-06-1.

摘要

葡萄糖-6-磷酸脱氢酶(G6PD)缺乏是新生儿严重高胆红素血症、黄疸持续时间延长和胆红素诱导的脑病的病因之一。在一项随机对照试验中,我们评估了口服熊去氧胆酸(UDCA)对需要光疗的G6PD缺乏新生儿间接高胆红素血症的影响。干预组I(N = 45;接受光疗和10 mg/kg/天的UDCA),干预组II(N = 40;接受光疗和20 mg/kg/天的UDCA),以及对照组(N = 49;接受光疗和安慰剂)。所有3组的血清总胆红素(TSB)水平均随时间显著下降(P = 0.001),但入院后不同时间点的TSB水平及光疗持续时间在3组间无显著差异。出院后,2个干预组的再入院率显著低于对照组(P = 0.001)。10 mg/kg/天组和20 mg/kg/天组之间未观察到显著差异。建议进一步评估,特别是关于UDCA在新生儿中的药代动力学。IRCT20091201002801N4,于2019年6月1日进行前瞻性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b23/9940175/54585db77048/10.1177_2333794X231156055-fig1.jpg

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