| The Effect of Phototherapy on Serum bilirubin Binding Capacity and Affinity in the Neonate. |
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In Suck Ryu, Chul Lee, Ran Namkung, Dong Gwan Han |
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Department of Pediatrics, Yonsei University, College of Medicine Seoul, Korea |
| 신생아 황달에서 광선치료가 혈청 알부민의
빌리루빈 결합능력에 미치는 영향 |
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유인석, 이철, 남궁란, 한동관 |
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연세대학교 의과대학 소아과학교실 |
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Received: 20 April 1990 • Accepted: 17 June 1990 |
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| Abstract |
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Since the effect of phototherapy in the treatment of neonatal hyperbilirubinemia has been reported
30 years ago, phototherapy has been used widely for neonatal hyperbilirubinemia, but the exact
mechanism and the effect of light on the human body have not been fully determined.
Free bilirubin level in the serum is an important indicator for kemicterus, a complication of
neonatal hyperbilirubinemia. Free bilirubin level was determined by the affinity and binding capacity
of bilirubin to serum albumin.
Light-induced changes in the albumin molecule, or competitive binding of a phototherapy break-
down product to albumin, could decrease the binding capacity and affinity of serum albumin to
bilirubin and render such therapy self-defeating.
20 infants bom in Yongdong Severance Hospital who were treated for physiologic jaundice during
the period between October 1988 and February 1989 were entered in the study. Serum free bilirubin
concentration was determined by automated peroxidase micromethod. Each serum was titrated for
the determination of bilirubin binding capacity and affinity by serial additions of small aliquots of
bilirubin to the serum. Scatchard plot was used to estimate the binding capacity and affinty of
bilirubin to albumin.
The level of bilirubin in sera of pre and post phototherapy were 12.9 ±1.80 mg/dl and 8.30 ±1.99 mg/
dl respectively.
There was no significant difference between albumin biniding capacity to bilirubin before (25.846 ±
3.069 mg/dl) and after (26.613 ±2.655 mg/dl) therapy.
The molar ratio of bilirubin and albumin before and after treatment showed no significant
difference (0.792±0.093 and 0.752±0.115 respectively).
Albumin binding affinity to bilirubin before (13.102 x 107/M) and after treatment (14.647 x 107/M)
showed no significant difference.
We concluded that phototherapy for 48 hours has no influence on albumin-bilirubin binding
capacity and affinity. |
| Key Words:
Bilirubin, Phototherapy |
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