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[体重<1500克早产儿的硒状态与支气管肺发育不良]

[Selenium status and bronchopulmonary dysplasia in premature infants <1,500 g].

作者信息

Merz U, Peschgens T, Dott W, Hörnchen H

机构信息

Kinderklinik, RWTH Aachen.

出版信息

Z Geburtshilfe Neonatol. 1998 Sep;202(5):203-6.

PMID:9857446
Abstract

Selenium is an essential component of the antioxidant enzyme glutathione peroxidase that protects tissues against oxidative injury by detoxifying peroxides. In preterm infants the risk for selenium deficiency is increased due to insufficient selenium uptake. Low selenium uptake and as a consequence decreased glutathione peroxidase activity may result in an elevated risk for the development of bronchopulmonary dysplasia (BPD). The aim of this prospective study was to investigate the relationship between the selenium status of preterm infants < 1500 g and the incidence of BPD. We determined the selenium plasma levels by means of atomic absorption spectrometry in 34 VLBW infants (mean birth weight 1075 +/- 249 g; mean gestational age 28.6 +/- 2.5 weeks) within the first 5 days of life and later in the age of 4 weeks. The infants received mainly parenteral nutrition and were not specifically supplied with selenium. Postnatally, the selenium plasma level was 34.2 micrograms/l (17.3/50) [median (25/75% quantil)] and dropped after 4 weeks to a median value of 16.1 micrograms/l (5.2/38.4) (p < 0.001). In the infants with BPD (n = 12) the selenium concentration within the first week of life was 45.0 micrograms/l (31.5/55.6) versus 33.2 micrograms/l (20.2/42.4) in the infants without BPD. In the age of 4 weeks of life the median selenium level was not significantly different between the infants with and without BPD - 17.2 micrograms/l (10.3/22.5) versus 14.8 micrograms/l (8.8/22.6).

摘要

硒是抗氧化酶谷胱甘肽过氧化物酶的重要组成部分,该酶通过使过氧化物解毒来保护组织免受氧化损伤。由于硒摄入不足,早产儿缺硒风险增加。低硒摄入以及由此导致的谷胱甘肽过氧化物酶活性降低,可能会增加支气管肺发育不良(BPD)的发生风险。这项前瞻性研究的目的是调查出生体重<1500g的早产儿的硒状态与BPD发病率之间的关系。我们采用原子吸收光谱法测定了34例极低出生体重儿(平均出生体重1075±249g;平均胎龄28.6±2.5周)出生后5天内及4周龄时的血浆硒水平。这些婴儿主要接受肠外营养,未特意补充硒。出生后,血浆硒水平为34.2微克/升(17.3/50)[中位数(第25/75百分位数)],4周后降至中位数16.1微克/升(5.2/38.4)(p<0.001)。患有BPD的婴儿(n=12)出生后第一周的硒浓度为45.0微克/升(31.5/55.6),而未患BPD的婴儿为33.2微克/升(20.2/42.4)。在4周龄时,患BPD和未患BPD的婴儿的硒水平中位数无显著差异——分别为17.2微克/升(10.3/22.5)和14.8微克/升(8.8/22.6)。

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