未熟児網膜症に対するビタミンEの効果について（II）

Effects of vitamin E on retinopathy of prematurity (II)

　1977年1月から1984年12月までに名市大新生児集中治療室（NICU）で管理され，1年間以上経過観察のできた出生体重1,500g未満の極小未熟児は138例で，このうちビタミンE非投与群は67例，ビタミンE筋肉内総投与量が40mg／kgをこえる過剰投与群は33例，ビタミンE筋肉内総投与量が40mg／kgの至適投与群は38例であった．これら3群について，網膜症の発生・進行および瘢痕化とビタミンE投与の関連性について検討し，以下の結果を得た．

（1）ビタミンEによる網膜症の発生予防，進行防止効果は認められない．

（2）ビタミンE過剰投与は，敗血症，感染症を増加させ，網膜症を重症化させる．

（3）ビタミンEによる網膜症瘢痕化の軽減効果もない．

We evaluated the possible beneficial effect of systemic vitamin E therapy in 138 premature infants during the past 8 years (1977-1984). The birth weight was under 1,500 g in all the cases. We took into consideration, as parameters, the incidence, severity and residual lesions of retinopathy of prematurity (ROP).

The series was divided into 3 groups : untreated group of 67 infants, megadose group of 33 infants who received over 40 mg/kg of intramuscular vita-min E, and optimum dose group who received 40 mg/kg of i. m. vitamin E. There were no significant differences among the 3 groups as to birth weight, gestational age and the incidence of ROP. There was, however, a significantly high incidence ofadvanced ROP of stage 3, middle substage, or more in the megadose group as compared with the untreated group.

There was no significant difference in the sever-ity of ROP between the untreated group and the optimum dose group. No differences were noted among the three groups regarding the relationship between the active changes and the cicatricial resid-ual lesions. There was a significantly higher inci-dence of septicemia and systemic infection in the megadose group than in the other two groups. Accordingly, a majority of infants with severe ROP were in the megadose group.

We conclude from the present results that sys-temic vitamin E administration has no beneficial effects on the incidence, severity or residua of ROP.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(5) : 487-491, 1987