新生児呼吸障害症の交換輸血療法に関する臨床生化学的研究 : 赤血球内解糖系の動態を中心に
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概要
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Study has been made mainly on glycolytic metabolism in erythrocytes in order to examine how the exchange transfusion effects the oxygen transport system of infants. 1. In the case of infants without RDS. a) Compared with the normal adults, activity of PK, G-6-PD and PGK in red cells was high and PFK was inert for both normal mature babies and preterm infants. b) 2, 3-diphosphoglycerate (2, 3-DPG) content and effective DPG fraction (EDPG) level of the preterm infants were lower than those of the normal adults and normal mature babies. c) Higher ratio of fetal hemoglobin (Hb-F) in red cells was observed in the order of (1) preterm infants > (2) normal mature babies > (3) normal adults. 2. In the case of infants with RDS. In the severe period of respiratory distress, the 2, 3-DPG content as well as PFK activity was remarkably low, but an upward tendency in them was observed in accordance with improvement of the respiratory distress. 3. Results of the study on the blood used for exchange transfusion. a) The blood content after exchange transfusion greatly reflected the content of the blood used for the exchange transfusion. b) More 2, 3-DPG was contained and pH was higher in the order of (1) fresh heparinized blood > (2) "fresh" ACD blood > (3) "old" ACD blood. 4. Exchange transfusion was carried out on seven cases of infants with RDS, and six cases were revealed as effective. (Conclusion) These results suggest that, for the infants with RDS having red cells with higher Hb-F ratio and lower 2, 3-DPG content compared with the red cells of the adult, it improves function to deliver oxygen to the tissue and is clinically effective when exchange transfusion is carried out by using fresh heparinized blood of the adult.