日本未熟児新生児学会雑誌　第19巻　第1号　99～104頁（2007年）

日本未熟児新生児学会雑誌　19(1)：99-104；2007　

受付日：平成18．04．28

受理日：平成18．06．30

当院NICUにおける一酸化窒素（NO）吸入療法に関する検討

Retrospective Study of Infants Treated with Inhaled Nitric Oxide in the Neonatal Intensive Care Unit

大分県立病院総合周産期母子医療センター　新生児科

Department of Neonatology, Oita Prefectural Hospital, Center for Perinatal Medicine

古賀寛史・高橋瑞穂・園田和孝・井上和彦・飯田浩一

Hiroshi KOGA，Mizuho TAKAHASHI，Kazutaka SONODA，Kazuhiko INOUE，Kouichi IIDA

Key Words：persistent pulmonary hypertension of the newborn（PPHN），nitric oxide（NO），congenital diaphragmatic hernia，oxygenation index，A-aDO2

　1996年から2005年までの10年間に当院NICUで一酸化窒素（NO）吸入療法を行った27症例について後方視的に検討を行った。肺高血圧症の原因疾患別の内訳は，新生児仮死・胎便吸引症候群に伴う新生児遷延性肺高血圧症 14例，先天性横隔膜ヘルニア7例，先天性心疾患3例，Dry lung syndrome 3例であった。前二者において生存例と死亡例を比較検討した。NO吸入開始前のoxygenation index，A-aDO2は両群間で差を認めなかったが，生存例はNO吸入開始後2時間以内にいずれも有意に低下し，酸素化の改善を認めた。一方，死亡例は酸素化が改善せず，吸入開始後2～8時間以内より両群間の酸素化能に差を認めた。NO吸入療法導入前後で生存率に差はなかった。

　We retrospectively investigated 27 infants who were treated with inhaled nitric oxide（NO）in our neonatal intensive care unit（NICU）for the 10-year period from 1996 to 2005.
　The primary diseases that resulted in pulmonary hypertension were as follows：14 cases of persistent neonatal pulmonary hypertension associated with birth asphyxia and meconium aspiration syndrome, 7 cases of congenital diaphragmatic hernia, 3 cases of congenital heart disease and 3 cases of dry lung syndrome.
　In the groups with persistent neonatal pulmonary hypertension and congenital diaphragmatic hernia, the results were compared between alive and dead infants.
　There were no differences between the surviving and nonsurviving groups for the oxygenation index and A-aDO2 before the beginning of NO inhalation. However, in the surviving group, the oxygenation index and A-aDO2 decreased significantly within 2 hours after the beginning of NO inhalation, suggesting improved oxygenation.
　In the nonsurviving group, oxygenation was not improved and there were differences in oxygenation 2 to 8 hours after the beginning of NO inhalation between the groups.
　No difference was found in the survival rate between before and after the induction of NO inhalation.