Inder T E, Graham P, Sanderson K, Taylor B J
Department of Paediatrics and Child Health, Dunedin Hospital, Dunedin, New Zealand.
Arch Dis Child Fetal Neonatal Ed. 1994 Mar;70(2):F107-11. doi: 10.1136/fn.70.2.f107.
(ABSTRACTOxygen free radical mediated tissue injury is implicated as a major factor in the pathogenesis of the long term complications seen in the premature infant, and direct evidence of their role in the development of these long term problems is lacking. A prospective observational study of 78% of very low birthweight infants admitted to a level III neonatal intensive care unit in 1992 was undertaken to determine the relationship between lipid peroxidation products, antioxidant activity, and outcome. Lipid peroxidation (malondialdehyde-thiobarbituric acid, MDA-TBA) and antioxidant activity (vitamin E and glutathione peroxidase activity) were measured in 22 very low birthweight infants in the cord blood and the infant's blood at 24 hours, 48 hours, and 1 week of age and correlated with outcome measures. The normal range for these measures was established in the cord blood samples of 48 consecutive healthy full term infants. The concentration of MDA-TBA at 1 week correlated with the number of days of oxygen treatment and number of days of positive pressure ventilatory support. Controlling for gestational age and antenatal complications simultaneously the MDA-TBA concentration remained significantly associated with the number of days of oxygen treatment and the number of days of positive pressure ventilatory support. Glutathione peroxidase was low in the premature and full term infants consistent with the low concentrations of selenium known to be present in southern New Zealand. There was evidence of a quadratic relationship between vitamin E at 1 week and the total number of days of supplementary oxygen requirement, with both high and low values associated with increased oxygen requirement. This association, however, did not remain after controlling for gestational age and antenatal complications. These results support the role of oxygen free radicals in mediating tissue damage associated with the development of chronic lung disease in the premature infant.
（摘要）氧自由基介导的组织损伤被认为是早产儿长期并发症发病机制中的一个主要因素，但缺乏其在这些长期问题发展中作用的直接证据。对1992年入住三级新生儿重症监护病房的78%极低出生体重儿进行了一项前瞻性观察研究，以确定脂质过氧化产物、抗氧化活性与预后之间的关系。在22例极低出生体重儿的脐血以及出生后24小时、48小时和1周时的婴儿血液中测量脂质过氧化（丙二醛 - 硫代巴比妥酸，MDA - TBA）和抗氧化活性（维生素E和谷胱甘肽过氧化物酶活性），并将其与预后指标相关联。在48例连续健康足月儿的脐血样本中确定了这些指标的正常范围。1周时MDA - TBA的浓度与吸氧治疗天数和正压通气支持天数相关。同时控制胎龄和产前并发症后，MDA - TBA浓度仍与吸氧治疗天数和正压通气支持天数显著相关。早产和足月儿的谷胱甘肽过氧化物酶水平较低，这与新西兰南部已知的低硒浓度一致。有证据表明1周时维生素E与补充氧气需求的总天数之间存在二次关系，高值和低值均与氧气需求增加相关。然而，在控制胎龄和产前并发症后，这种关联不再存在。这些结果支持氧自由基在介导与早产儿慢性肺病发展相关的组织损伤中的作用。
