Fat emulsion given to very low-birthweight infants increases urinary L-FABP
Fat emulsion given to very low-birthweight infants increases urinary L-FABP
复制标题
极低出生体重婴儿服用脂肪乳会增加尿 L-FABP
作者：
Suganuma H;Ikeda N;Ohkawa N;Nagata S;Shoji H;Shimizu T
背景早产儿肾小管功能受多种因素影响，如窒息、呼吸障碍、高氧血症、低血压、药物治疗等。当肾微循环病理导致肾小管缺血和氧化应激时，尿芳基型脂肪酸结合蛋白(L-FABP)水平升高。方法对极低出生体重儿(极低出生体重儿)随时间变化测定尿芳基脂结合蛋白水平，并观察脂肪乳剂对其影响。将31例极低体重儿按脂肪乳剂治疗分为两组：脂肪乳组(n= )20例，对照组( )11例。结果脂肪乳组和对照组治疗前尿芳基中位数分别为459 ng/mgcr(范围22.7~5100 ng/mgcr，平均1067 ± 1570 ng/mgcr)和797 ng/mgcr(范围69~3900 ng/mgcr；平均1066 ± 1188 /mgcr)，差异无统计学意义。7日龄至14日龄尿醛酸脂结合蛋白水平中位数分别为624 ng/mg cr(范围50-2050 ng/mgcr；平均 ± SD，799 ± 655 ng/mgcr)和273 ng/mgcr(范围31-987 ng/mgcr；平均 ± sd，359 ± 323 ng/mgcr)，表明高脂组水平显著高于高脂组。在21~28日龄，中位数分别为462 ng/mg cr(范围49~1867 ng/mgcr；平均 ± sd，557 ± 534 ng/mgcr)和130 ng/mgcr(范围20~993 ng/mgcr；平均 ± sd，290 ± 329 ng/mgcr)。
BackgroundIn premature infants, many factors influence the function of renal tubules, such as asphyxia, respiratory disorders, use of high‐concentration oxygen, hypotension, and drug treatment. When tubular ischemia and oxidative stress develop due to renal microcirculatory pathology, urinaryl‐type fatty acid‐binding protein (l‐FABP) level increases.MethodsUrinaryl‐FABP level was measured over time in very low‐birthweight infants (VLBWI), and the effect of fat emulsion onl‐FABP level was investigated. Thirty‐one VLBWI were divided into two groups with regard to treatment with fat emulsion: the lipid group (n= 20) and the control group (n= 11). Urinaryl‐FABP was measured before (0–3 days of age), during (7–14 days of age), and after fat emulsion treatment (21–28 days of age) in the two groups.ResultsMedian urinaryl‐FABP level before treatment was 459 ng/mgCr (range, 22.7–5100 ng/mgCr; mean, 1067 ± 1570 ng/mgCr) and 797 ng/mgCr (range, 69–3900 ng/mgCr; mean, 1066 ± 1188 ng/mgCr) in the lipid and control groups, respectively, showing no significant difference. Median urinaryl‐FABP level was 624 ng/mgCr (range, 50–2050 ng/mgCr; mean ± SD, 799 ± 655 ng/mgCr) and 273 ng/mgCr (range, 31–987 ng/mgCr; mean ± SD, 359 ± 323 ng/mgCr) at 7–14 days of age, respectively, showing that the level was significantly higher in the lipid group. At 21–28 days of age, the median level was 462 ng/mgCr (range, 49–1867 ng/mgCr; mean ± SD, 557 ± 534 ng/mgCr) and 130 ng/mgCr (range, 20–993 ng/mgCr; mean ± SD, 290 ± 329 ng/mgCr), respectively, showing thatl‐FABP level tended to be higher in the lipid group.ConclusionsFat emulsion treatment induced a significant increase in urinaryl‐FABP level, suggesting that fat emulsion affected the proximal tubule in VLBWI.