CAJ | 학술논문

目的：探讨早期联合应用复合辅酶及维生素E对新生儿高胆红素血症肝肾功能损害的干预效果。方法150例足月高胆红素血症新生儿作为观察组，据胆红素值分为轻、中、重3组，另选取同期出生的健康无黄疸或生理性黄疸的足月新生儿共45例作为对照组。入院24 h内检测血清γ-谷氨酰转移酶（γ-GGT）、总胆红素及胱抑素C （Cys-C）、丙二醛（MDA）等指标。另将观察组随机分为常规组和联合组。联合组早期给予复合辅酶、维生素E以及常规治疗，常规组仅给予常规干预，治疗1周复查以上指标。结果治疗前轻、中、重度组MDA均较对照组增高（P＜0.05），而γ-GGT及Cys-C仅在中、重度组较对照组升高（P＜0.05），且总胆红素与MDA、γ-GGT及Cys-C水平间呈正相关（P＜0.05），MDA与Cys-C、γ-GGT间亦呈正相关（P＜0.01）。经早期干预治疗后，随着胆红素下降，血γ-GGT及Cys-C、MDA等亦有所降低，其中联合组较常规组降低更显著（P＜0.05）。结论高胆红素血症时，可能通过胆红素诱导的脂质过氧化作用对新生儿肝肾造成损害，在常规治疗基础上加用复合辅酶及维生素E有一定的保护作用。
목적：탐토조기연합응용복합보매급유생소E대신생인고담홍소혈증간신공능손해적간예효과。방법150례족월고담홍소혈증신생인작위관찰조，거담홍소치분위경、중、중3조，령선취동기출생적건강무황달혹생이성황달적족월신생인공45례작위대조조。입원24 h내검측혈청γ-곡안선전이매（γ-GGT）、총담홍소급광억소C （Cys-C）、병이철（MDA）등지표。령장관찰조수궤분위상규조화연합조。연합조조기급여복합보매、유생소E이급상규치료，상규조부급여상규간예，치료1주복사이상지표。결과치료전경、중、중도조MDA균교대조조증고（P＜0.05），이γ-GGT급Cys-C부재중、중도조교대조조승고（P＜0.05），차총담홍소여MDA、γ-GGT급Cys-C수평간정정상관（P＜0.05），MDA여Cys-C、γ-GGT간역정정상관（P＜0.01）。경조기간예치료후，수착담홍소하강，혈γ-GGT급Cys-C、MDA등역유소강저，기중연합조교상규조강저경현저（P＜0.05）。결론고담홍소혈증시，가능통과담홍소유도적지질과양화작용대신생인간신조성손해，재상규치료기출상가용복합보매급유생소E유일정적보호작용。
Objective To study the effect of coenzymes complex combined with vitamin E on liver and kidney inju-ry induced by neonatal hyperbilirubinemia. Methods One hundred and fifty full-term neonatals with hyperbilirubinemia were chosen as observation groups, who were divided into mild, moderate and severe groups according bilirubin. Forty five healthy full-term newborns in the same period, who are either healthy or with physiological jaundice, were selected as con-trol group. Serum total bilirubin, gamma-glutamyl transferase (γ-GGT) , Malondialdehyde (MDA) and Cys-C were measured within 24 hours of hospital admission.The observation groups were randomly divided into regular and combined treatment groups. Coenzymes complex combined with vitamin E were given in addition to regular method to combined group while reg-ular group only received regular methods.All above biochemical indexes were tested in the 7th day after medication admin-istration. Results Serum MDA were higher in all observation groups (mild, moderate and severe groups) than in control group (P<0.05);but the levels ofγ-GGT and Cys-C increased in moderate and severe groups compared with control group (P<0.05). There were positive correlations (P<0.05) between levels of serum total bilirubin with MDA,γ-GGT and Cys-C. Positive linear correlation were found between MDA with γ-GGT and Cys-C(P<0.01). After early intervention,γ-GGT, Cys-C and MDA declined with drop of bilirubin level. This is more prominent and faster in a in combined treatment group than regular group (P<0.05).Conclusion In hyperbilirubinemia newborns, lipid peroxidation activated by bilirubin may lead to damages of liver and kidney. Coenzymes combined with vitamin E have protective effect to these damages.