还原型谷胱甘肽联合苯巴比妥治疗新生儿黄疸的疗效分析

Efficacy of reduced glutathione combined with phenobarbital in treating neonatal jaundice

摘要:

目的 分析还原型谷胱甘肽联合苯巴比妥治疗新生儿黄疸的效果。方法 选取2015年4月—2019年12月联勤保障部队第904医院收治的84例黄疸新生儿，以随机数字表法分为研究组和对照组，每组42例。两组均给予常规光疗，对照组在常规治疗基础上给予苯巴比妥，研究组在对照组基础上再给予还原型谷胱甘肽，两组均持续治疗7 d评价效果。对比两组光疗时间、皮肤退黄时间、肝功能、临床疗效、外周血细胞因子、免疫功能及治疗期间药物不良反应。结果 研究组光疗时间、皮肤退黄时间均低于对照组（P <0.05）。研究组治疗前后丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、转铁蛋白、总胆汁酸、CD4^＋/CD8^＋的差值均高于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 还原型谷胱甘肽联合苯巴比妥治疗新生儿黄疸可增强疗效，缩短光疗时间，促进黄疸消退，改善肝功能、TRF、TBA及免疫应答功能，且安全性良好。

Abstract:

Objective To analyze the efficacy of reduced glutathione combined with phenobarbital in the treatment of neonatal jaundice.Methods Eighty-four neonates with jaundice treated in the 904th Hospital of Joint Logistics Support Force of Chinese PLA from April 2015 to December 2019 were selected and divided into the study group and the control group by random number table method, with 42 cases in each group. Both groups received conventional phototherapy. Besides, the control group was given phenobarbital on the basis of conventional treatment, and the study group was given glutathione in addition to conventional phototherapy and phenobarbital. Both groups were treated continuously for 7 days to evaluate the therapeutic efficacy. The duration of phototherapy, time to recovery from jaundice, liver function, clinical efficacy, peripheral blood cytokines, immune function and adverse drug reactions during treatment were compared between the two groups.Results The duration of phototherapy and time to recovery from jaundice in the study group were shorter than those in the control group (P < 0.05). The differences of the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), transferrin (TRF) and total bile acid (TBA) as well as the ratio of CD4⁺/CD8⁺ cells before and after treatment in the study group were higher than those in the control group (P < 0.05). The overall effective rate in the study group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of overall adverse reactions between the two groups (P > 0.05).Conclusions In the treatment of neonatal jaundice, reduced glutathione combined with phenobarbital enhances the therapeutic efficacy, shortens the duration of phototherapy, promotes the recovery from jaundice, improves the liver function and modulates the levels of TRF and TBA and the immune responses with a good safety profile.