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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 60-61页

作者： Hamon I. fresson j. Nicolas M.-B. 宁亮 Reanimation Neonatale Maternite Regionale Univ. de Nancy 10 rue du Dr Heydenreich 54 042 Nancy Ced ex France Dr.

Inhaled nitric oxide (iNO) improves oxygenation in premature infants, but conc ern has been raised about its potential oxidative toxicity. We designed this stu dy to assess the oxidative balance in premature infants who were exposed to low dose iNO and the relationship with their clinical outcome on day 28 of life. Ato tal of 274 infants who were < 32 wk gestation were randomized at birth to receiv e 5 ppm of iNO if they presented with hypoxemic respiratory failure. Nonhypoxemi c infants were studied as the reference group. Blood samples were withdrawn 24 h apart, within the first 4 d of life, to assess malondialdehyde (MDA)-concentra tion as oxidative stress marker and total plasmatic glutathione (GSH), intraeryt hrocyte GSH peroxidase, and GSH reductase activities as antioxidant defenses. Af ter 24 h, the rise in MDA was blunted in the iNO group compared with controls an d was close to the reference infants. Conversely, GSH was more stable in the iNO group, when there was no difference for the GSH peroxidase and GSH reductase ac tivities. On day 28, Oxygen dependence was linked with a higher increase in MDA as was the risk for death, whereas intraventricular hemorrhage was associated wi th a higher initial drop in GSH. Early low-dose iNO in hypoxemic preterm infant s improves oxidative balance and seems to be clinically beneficial up to day 28 of life.

关键词：氧化应激采集血样还原酶活性过氧化酶出生后低氧血症呼吸困难参照组谷胱甘肽

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早产儿使用一氧化氮治疗的安全性与疗效

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世界核心医学期刊文摘（儿科学分册） 2005年第8期1卷 23-23页

作者： Hascoet j.M. fresson j. Claris O. 贺莉 Neonatology Department Maternite Regionale Universi- taire 10 rue du Dr Heydenreich 54042 Nancy France Dr.

Obj.ctives: To assess the safety- efficacy balance of low- dose inhaled nit ric oxide (iNO) in hypoxemic premature infants because no sustained beneficial e ffect has been demonstrated clearly and there are concerns about side effects. S tudy design: Eight hundred and sixty infants 40% , and arterio- alveolar ratio in oxygen (aAO2) < 0.22. The primary end point was intact survival at 28 days of age. Results: Sixt y- one of 415 infants presented with HRF and were compared with 84 of 445 contr ols who presented with HRF. There was no difference in the primary end point (61 .4% in infants [23% with HRF who were treated with iNO] vs 61.1% in contro ls [21.4% in controls with HRF]; P =. 943). For the infants with HRF who were treated with iNO, there was no significant difference from controls for intraven tricular hemorrhage (IVH) (6% vs 7% ), necrotizing enterocolitis (8% vs 6 % ), or patent ductus arteriosus (PDA) (34% vs 37% ). Compared with nonhypoxem ic infants, the risk of bronchopulmonary displasia (BPD) increased significantly in HRF controls (OR = 3.264 [CI 1.461- 7.292]) but not in infants with HRF who were treated with iNO (OR = 1.626 [CI 0.633- 4.178]). Conclusions: iNO appears to be safe in premature infants but did not lead to a significant improvement i n intact survival on day 28.

关键词：脑室内出血安慰剂低氧血症存活者呼吸衰竭机械通气无显著性差异研究设计生时

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