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題 名 | Effects of Intravenous Immunoglobulin Administration on Serum Levels of Nitric Oxide Products in Newborn Infants with Sepsis=靜脈注射免疫球蛋白對新生兒敗血症患者血中氧化氮濃度的影響 |
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作 者 | 謝武勳; 楊鵬弘; | 書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 4:3 2002.07[民91.07] |
頁 次 | 頁147-153 |
分類號 | 417.517 |
關鍵詞 | 免疫球蛋白; 氧化氮; 亞硝酸鹽; 硝酸鹽; 敗血症; 新生兒; Intravenous immunoglobulin; Nitric oxide; Nitrite; Nitrate; Sepsis; Neonate; |
語 文 | 英文(English) |
中文摘要 | 由於免疫系統的不健全,新生兒罹患敗血症時可能造成生命的危險。因此在治療新生兒敗血症,除了及時的正確診斷與使用抗生素外,有人嘗試另使用免疫球蛋白,以加強療效及降低死亡率。免疫球蛋白會有臨床助益,其作用可能包括調節發炎介質的製造,抑制發炎細胞的受體,提供具調節作用的抗體,中和毒素的抗原及影響補體系統等。 近年的研究證實氧化氮在人體的生理變化中扮演著非常重要的角色。它是一種高活性的氣體分子,溶於水,可經由内皮細胞、神經細胞、巨噬細胞及嗜中性白血球被製造出;它的作用包括鬆弛平滑肌、擴張血管、神經的傳導及調節免疫及血小板功能等。有些研究發現,在新生兒敗血症患者血中的氧化氮產物,包括亞硝酸鹽(Nitrite)及硝酸鹽(Nitrate)會有昇高的現象,尤其是在發生敗血性休克的嬰兒,血中濃度會更高;可能是感染造成氧化氮的製造增加,而引起不當的血管擴張,導致敗血性休克。本研究收集罹患敗血性的新生兒34例,除了抗生素使用外,其中14位另給與連續三天的靜脈注射免疫球蛋白,其劑量為每天每公斤250毫克。在注射前及注射後48及144小時,分別抽血作血液血球分析及測定氧化氮產物之血中濃度值,並嚴格監控其臨床變化。我們的結果顯示靜脈注射免疫球蛋白於新生兒敗血症的患例,並無明顯的副作用;在注射48及144小時後,對於血中氧化氮產物的濃度並無統計上有意義的影響。我們推測也許是因為在注射免疫球蛋白後,氧化氮受到的影響發生時間更早,而未能偵測出其變化,此外也可能是因為研究的病例中較少發生敗血性休克之故等等,值得進一步的探討。 |
英文摘要 | Objective. Nitric oxide (NO) is thought to play an important role in the mediation of sepsis. Intravenous immunoglobulin (IVIG) has been reported as an effective adjunct therapy to reduce the morbidity and mortality of neonatal sepsis. The aim of this study was to investigate the correlation between IVIG administration and the serum level of NO products in newborn infants with sepsis. Methods. A prospective study was undertaken on those newborn infants with suspected sepsis or culture-proved sepsis in the Neonatology Unit of Chang Gung Children's Hospital from September 1, 2000 to August 31, 2001. All infants were treated with antibiotics including ampicillin and gentamicin, while the immunotherapy group received IVIG administration (250 mg/kg/day) as an adjunct therapy for three consecutive days. Blood samples were collected for serum No end product (nitrite and nitrate) levels using a chemiluminescene NO analyzer on days 1 (before IVIG), 3, and 7. Results. Thirty-four newborn infants were enrolled in this study. 14 of them received IVIG treatment. There was no significant difference between the two groups in either gestational age (33.8±3.9 wks vs 31.8±4.6 wks) or birth weight (2170±941 gms vs 1881±820 gms). By multiple linear regression analysis, the serum levels of NO products were not affected by the treatment of IVIG (p=0.238), birth weight (p=0.979), and time course (p=0.969). Conclusions. This study suggested that there were no effects of IVIG administration on serum levels of NO products in newborn infants with sepsis. |
本系統中英文摘要資訊取自各篇刊載內容。