Odell G B, Gutcher G R, Whitington P F, Yang G
Pediatr Res. 1983 Oct;17(10):810-4. doi: 10.1203/00006450-198310000-00009.
Phototherapy increases the biliary excretion of unconjugated bilirubin. In this form, bilirubin would be subject to enterohepatic circulation, and the true efficacy of phototherapy would be blunted. We tested the hypothesis that sequestration of lumenal unconjugated bilirubin by enteral agar administration would enhance the efficacy of phototherapy in jaundiced infants. Fifty-two infants were studied, 21 control and 31 agar-supplemented. The birth weights, sex distribution, and postnatal age at onset of phototherapy did not differ between the two groups of infants; pre- and post-phototherapy bilirubin concentrations also did not differ between the groups. The bile acid concentrations and bilirubin saturation indices were also similar. The rate of declination of the plasma bilirubin concentrations after 24 h of phototherapy was greater and significantly more uniform in the agar-supplemented infants (-1.59 +/- 2.3 versus -2.51 +/- 1.44). Stool frequencies were greater in control infants (5.5 versus 4.3 per 24 h) whereas fecal bilirubin excretions were greater in agar-supplemented infants during the second day of phototherapy (1.32 versus 3.29 mg . kg-1 . 24 h-1). Agar supplementation reduced the duration of phototherapy by 23% (37.6 +/- 3.2 versus 48.1 +/- 5.0 h).
光疗可增加未结合胆红素的胆汁排泄。在这种形式下，胆红素会进行肠肝循环，从而削弱光疗的真正疗效。我们检验了这样一个假设，即通过口服琼脂隔离肠腔内的未结合胆红素可提高光疗对黄疸婴儿的疗效。对52名婴儿进行了研究，其中21名作为对照组，31名补充琼脂。两组婴儿的出生体重、性别分布以及开始光疗时的出生后年龄并无差异；两组婴儿光疗前后的胆红素浓度也无差异。胆汁酸浓度和胆红素饱和指数也相似。光疗24小时后，补充琼脂的婴儿血浆胆红素浓度下降速度更快，且明显更均匀（-1.59±2.3对-2.51±1.44）。对照组婴儿的排便频率更高（每24小时5.5次对4.3次），而在光疗第二天，补充琼脂的婴儿粪便胆红素排泄量更大（1.32对3.29毫克·千克⁻¹·24小时⁻¹）。补充琼脂使光疗持续时间缩短了23%（37.6±3.2小时对48.1±5.0小时）。
