日本未熟児新生児学会雑誌　第22巻　第1号　49～55頁（2010年）

日本未熟児新生児学会雑誌　22(1)：49-55；2010　

受付日：平成21．04．01

受理日：平成21．06．24

青色発光ダイオードによる光線療法の有効性に関する検討

Blue Light-emitting Diode Phototherapy is More Effective Than Conventional Blue Fluorescent Tube Therapy in Treating Neonatal Hyperbilirubinemia

＊1名古屋市立大学大学院医学研究科　新生児・小児医学分野，＊2愛知県心身障害者コロニー中央病院　新生児科，＊3名古屋市立西部医療センター城北病院　小児科，＊4聖隷三方原病院　小児科，＊5海南病院　小児科

＊1Department of Pediatrics and Neonatology，Nagoya-City University Graduate school of Medical Sciences，＊2Department of Neonatology，Aichi Human service center Hospital，＊3Department of Pediatrics，Western Medical Center，Johoku Hospital，City of Nagoya，＊4Department of Pediatrics，Seirei Mikatahara General Hospital，＊5Department of Pediatrics，Kainan Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives

加藤　晋＊1・垣田博樹＊2・邊見勇人＊2・山田恭聖＊2・福田純男＊3・中島秀幸＊4・山田崇春＊5・Mohamed Hamed Hussein＊1・後藤盾信＊1・伊藤孝一＊1・上田博子＊1・杉浦時雄＊1・鈴木　悟＊1・伊藤哲哉＊1・加藤稲子＊1・戸苅　創＊1

＊1Shin KATO,＊2Hiroki KAKITA,＊2Hayato HEMMI,＊2Yasumasa YAMADA, ＊3Sumio FUKUDA,＊4Hideyuki NAKASHIMA,＊5Takaharu YAMADA, ＊1Mohamed Hamed Hussein,＊1Tatenobu GOTO,＊1Kouichi ITO,＊1Hiroko UEDA, ＊1Tokio SUGIURA,＊1Satoshi SUZUKI,＊1Tetsuya ITO,＊1Ineko KATO ,＊1Hajime TOGARI

Key Words：light emitting diode，phototherapy，bilirubin，（EZ）-cyclobilirubin，irradiance

　青色発光ダイオード（LED）による光線療法の効果を，従来の蛍光管（FT）による治療と後方視的に比較検討した。対象は出生体重1,500g以上の児58名で，総血清ビリルビン（TSB）の治療前後の値を検討した。機器は床面から50cmの高さで治療を行い，治療したタイプによりLED-high mode群（n＝14），LED-low mode群（n＝14），FT群（n＝30）に分けた。TSB変化量（TSB治療前－TSB治療後），照射時間あたりの変化量，TSB変化率（TSB変化量/TSB治療前×100），照射時間あたりの変化率，いずれもLED-high群がLED-low群とFT群に比較して有意に高値を示した。これまでのin-vitroの報告に加え，実際の治療でも青色LEDで有意に高い効果が得られることが示された。副作用やアンバウンドビリルビンに与える影響，超低出生体重児での効果などが今後の検討課題である。

　We performed a case-control study to evaluate the efficacy of blue light-emitting diode（LED）phototherapy in treating neonatal hyperbilirubinemia. Fifty-eight newborns with a body weight higher than 1,500 g at birth were included in this study and assigned to one of three groups according to the device providing phototherapy： a fluorescent tube （FT）group（n ＝ 30），an LED-high mode group（n ＝ 14）and an LED-low mode group（n ＝ 14）．Phototherapy was provided from 50 cm above their bed when their total serum bilirubin（TSB）levels exceeded the revised Murata’s criteria.
　The clinical backgrounds of the three groups did not differ. The mean total serum bilirubin（TSB）concentrations at initiation of treatment did not differ among the three groups. At termination of treatment, the mean TSB level in the LED-high mode group was significantly lower than in the FT group（10.6 ± 0.6 mg/dL vs. 12.7 ± 0.4 mg/dL）．The LED-high mode group had higher ⊿ TSB（TSB before − TSB after therapy）levels compared to the LED-low mode and the FT groups（5.5 ± 0.6 mg/dL vs. 1.7 ± 0.6 mg/dL vs. 2.9 ± 0.6 mg/dL），higher ratio of reduction in TSB ［（⊿ TSB/ TSB before therapy）× 100］（ 33.3± 3.0％ vs. 10.5± 4.2％ vs. 16.9± 3.3％），higher rate of decrease in TSB［ ⊿ TSB/ time （hr）］（0.21 ± 0.03 mg/dL/hr vs 0.10 ± 0.03 mg/dL/hr vs 0.10 ± 0.02 mg/dL/hr） and higher rate of decrease in their ratio of reduction in TSB［（⊿ TSB/TSB before therapy）× 100/time（hr）］（1.20 ± 0.11％ /hr vs. 0.45 ± 0.17％ / hr vs. 0.58 ± 0.11％ /hr），respectively.
　We showed that blue LED phototherapy was more effective than conventional blue FT phototherapy in treatment of neonatal hyperbilirubinemia. Evaluation of LED phototherapy in extremely low birth weight infants and a prospective randomized study would be beneficial in the future.