低出生体重児に対する静注用脂肪乳剤の臨床応用 : 血清 unbound bilirubin 値に及ぼす影響
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概要
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The effects of intravenously administered lipid (Intrafat) on plasma triglyceride, free fatty acid (FFA) and unbound bilirubin (U. B.) concentrations in low birth weight infants were investigated, and also, in this paper, the displacement of albumin-bound bilirubin by FFA was investigated experimentally. The interaction of bilirubin, FFA (linoleate or palmitate) and human plasma albumin was investigated in an isolated system. Increasing amounts of linoleate or palmitate were added to bilirubin-albumin solutions at a constant molar ratio, and then U. B. was measured by an enzymatic method employing peroxidase and glucose oxidase. In solutions with molar ratio bilirubin/albumin of 1.5, no displacement was evident when the molar ratio of FFA relative to albumin was below 3.0. Above molar ratio of FFA/albumin of 3.0, U. B. levels in this system rose sharply. In solutions with molar ratio bilirubin/albumin of 1.0 or 0.5, bilirubin were markedly dissociated from albumin when the molar ratio of FFA relative to albumin exceeded 4.0. On the other hand the interaction of FFA and newborn icteric sera was investigated similarly A remarkable displacement of bilirubin from albumin was observed when the molar ratio of FFA relative to albumin exceeded 4.0. Intrafat infusion therapy in a dose of 1.0g/kg of body weight over 6 hours was performed in low birth weight infants, in which two cases showed a conspicuous elevation of serum FFA levels subsequent to an elevation of serum triglyceride levels. The elevation of U. B. level should be evaluated rigorously, since it is presumable that the molar ratio of FFA relative to albumin exceeds 4.0, if Intrafat administration is performed to icteric low birth. weight infant, in whom low serum albumin level is expected.
- 神戸大学の論文