Change of bilirubin photoisomers in the urine and serum before and after phototherapy compared with light source

被引:6
作者
Okada, H
Masuya, K
Kurono, Y
Nagano, K
Okubo, K
Yasuda, S
Kawasaki, A
Kawada, K
Kusaka, T
Namba, M
Nishida, T
Imai, T
Isobe, K
Itoh, S
机构
[1] Kagawa Univ, Dept Pediat, Miki, Kagawa 7610793, Japan
[2] Kagawa Univ, Maternal Perinatal Ctr, Miki, Kagawa 7610793, Japan
关键词
biliblanket; blue-white light; green light; hyperbilirubinemia; lumirubin;
D O I
10.1111/j.1442-200x.2004.01973.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: The clinical effect of phototherapy for neonatal hyperbilirubinemia is based on the production and elimination of cyclobilirubin. Generally, the clinical effect of light sources is estimated by the reduction in the total serum bilirubin level. One procedure with less invasiveness than blood collecting is urine collection. Whether the effectiveness of light sources used for phototherapy could be assessed using measurements of bilirubin photoisomers in urine was studied. Methods: This study was a retrospective analysis of 38 term infants with hyperbilirubinemia who underwent phototherapy. Bilirubin fractions in serum and urine before and 24 h after the phototherapy were measured by high-performance liquid chromatography. The light sources used for the phototherapy were blue-white light (n = 11), Biliblanket plus high output (n = 13) or green light (n = 14). The relationships between serum and urine bilirubin photoisomers after phototherapy and whether the levels of urine bilirubin photoisomer are affected by the light sources with different wavelength characteristic were analyzed. Results: There was no correlation between serum (ZE)-bilirubin and urine configurational isomers, but a weak positive correlation between serum (EZ)-cyclobilirubin and urine structural isomers after phototherapy. Although serum (ZE)-bilirubin levels depended on the wavelength characteristic of each light source during phototherapy, the urine configurational isomer levels did not depend on it. The increase in serum (EZ)-cyclobilirubin levels and the urine structural isomer levels were mostly in agreement. Conclusions: The urine bilirubin structural isomers may be used to estimate the serum (EZ)-cyclobilirubin levels and to evaluate the clinical effects of light sources.
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收藏
页码:640 / 644
页数:5
相关论文
共 16 条
[1]   Bilirubin photoisomerization products in serum and urine from a Crigler-Najjar type I patient treated by phototherapy [J].
Agati, G ;
Fusi, F ;
Pratesi, S ;
Galvan, P ;
Donzelli, GP .
JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY, 1998, 47 (2-3) :181-189
[2]   EFFECT OF SPECTRAL DISTRIBUTION ON ISOMERIZATION OF BILIRUBIN INVIVO [J].
COSTARINO, AT ;
ENNEVER, JF ;
BAUMGART, S ;
SPECK, WT ;
POLIN, RA .
JOURNAL OF PEDIATRICS, 1985, 107 (01) :125-128
[3]   BLUE-LIGHT, GREEN LIGHT, WHITE-LIGHT, MORE LIGHT - TREATMENT OF NEONATAL JAUNDICE [J].
ENNEVER, JF .
CLINICS IN PERINATOLOGY, 1990, 17 (02) :467-481
[4]   PHOTOTHERAPY FOR NEONATAL JAUNDICE - INVIVO CLEARANCE OF BILIRUBIN PHOTOPRODUCTS [J].
ENNEVER, JF ;
KNOX, I ;
DENNE, SC ;
SPECK, WT .
PEDIATRIC RESEARCH, 1985, 19 (02) :205-208
[5]   DIFFERENCES IN BILIRUBIN ISOMER COMPOSITION IN INFANTS TREATED WITH GREEN AND WHITE-LIGHT PHOTOTHERAPY [J].
ENNEVER, JF ;
KNOX, I ;
SPECK, WT .
JOURNAL OF PEDIATRICS, 1986, 109 (01) :119-122
[6]   RAPID CLEARANCE OF A STRUCTURAL ISOMER OF BILIRUBIN DURING PHOTOTHERAPY [J].
ENNEVER, JF ;
COSTARINO, AT ;
POLIN, RA ;
SPECK, WT .
JOURNAL OF CLINICAL INVESTIGATION, 1987, 79 (06) :1674-1678
[7]   Accurate and sensitive high-performance liquid chromatographic method for geometrical and structural photoisomers of bilirubin IXα using the relative molar absorptivity values [J].
Itoh, S ;
Isobe, K ;
Onishi, S .
JOURNAL OF CHROMATOGRAPHY A, 1999, 848 (1-2) :169-177
[8]   Differences in transcutaneous bilirubin readings in Japanese term infants according to feeding method [J].
Itoh, S ;
Kondo, M ;
Kusaka, T ;
Isobe, K ;
Onishi, S .
PEDIATRICS INTERNATIONAL, 2001, 43 (01) :12-15
[9]  
ITOH S, 1987, BIOL NEONATE, V51, P10
[10]   URINARY-EXCRETION OF AN ISOMER OF BILIRUBIN DURING PHOTOTHERAPY [J].
KNOX, I ;
ENNEVER, JF ;
SPECK, WT .
PEDIATRIC RESEARCH, 1985, 19 (02) :198-201