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Risk factors for elevated serum total bile acid in preterm infants
SONG Yan-Ting, WANG Yong-Qin, ZHAO Yue-Hua, ZHU Hai-Ling, LIU Qian, ZHANG Xiao, GAO Yi-Wen, ZHANG Wei-Ye, SANG Yu-Tong
Chinese Journal of Contemporary Pediatrics ›› 2018, Vol. 20 ›› Issue (3) : 174-177.
PDF(899 KB)
PDF(899 KB)
Risk factors for elevated serum total bile acid in preterm infants
Objective To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. Methods A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA > 24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. Results The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (P < 0.05). The unconditional multivariate logistic regression analysis showed that low birth weight (OR=3.84, 95% CI:1.53-9.64) and neonatal sepsis (OR=2.56, 95% CI:1.01-6.47) were independent risk factors for elevated TBA in preterm infants. Conclusions Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.
[1] 府伟灵. 肝脏病常用实验室检测[M]//万学红, 卢雪峰. 诊断学. 第8版. 北京:人民卫生出版社, 2013:352-372.
[2] Li T, Apte U. Bile acid metabolism and signaling in cholestasis, inflammation, and cancer[J]. Adv Pharmacol, 2015, 74:263-302.
[3] Polkowska G, Polkowski W, Kudlicka A, et al. Range of serum bile acid concentrations in neonates, infants, older children, and in adults[J]. Med Sci Monit, 2001, 7(Suppl 1):268-270.
[4] 虞人杰, 叶鸿瑁, 朱建幸, 等. 新生儿窒息诊断的专家共识[J]. 中华围产医学杂志, 2016, 19(1):3-6.
[5] Burrin DG, Ng K, Stoll B, et al. Impact of new-generation lipid emulsions on cellular mechanisms of parenteral nutrition-associated liver disease[J]. Adv Nutr, 2014, 5(1):82-91.
[6] 张景阳, 冯芝雯, 黄为民. 早产儿胃肠外营养相关性胆汁淤积症的临床研究[J]. 中国妇幼保健, 2017, 32(13):2933-2935.
[7] Liu P, Guo L, Huang L, et al. Analysis of factors affecting the prognosis of neonatal cholestasis[J]. Int J Clin Exp Med, 2015, 8(5):8005-8009.
[8] 杨军, 李水霞, 陈莉娜. 极低出生体质量儿胃肠外营养相关性胆汁淤积危险因素临床分析[J]. 中华妇幼临床医学杂志(电子版), 2015, 11(5):559-563.
[9] Costa S, Maggio L, Sindico P, et al. Preterm small for gestational age infants are not at higher risk for parenteral nutrition-associated cholestasis[J]. J Pediatr, 2010, 156(4):575-579.
[10] 刘开琴, 刘海菊, 范久波, 等. 单纯血清总胆汁酸升高的临床价值[J]. 国际检验医学杂志, 2013, 34(9):1167-1169.
[11] 苏维, 宋新志, 邝爱玲, 等. 早期微量喂养可提高新生儿耐受并降低胆汁淤积[J]. 基因组学与应用生物学, 2017, 36(7):2717-2721.
[12] 罗晓红, 胡旭红. 早产儿早期肠内微量喂养对胃肠外营养相关性胆汁淤积发病的影响研究[J]. 成都医学院学报, 2015, 10(6):688-691.
[13] Dutta S, Singh B, Chessell L, et al. Guidelines for feeding very low birth weight infants[J]. Nutrients, 2015, 7(1):423-442.
[14] 周平, 陈睿, 邹彩艳, 等. 围产因素对早期早产儿淋巴细胞亚群演变趋势的影响[J]. 中国当代儿科杂志, 2016, 18(10):953-959.
[15] 马琳, 杨涛. TBA检测对新生儿溶血症的临床意义[J]. 中国妇幼保健, 2015, 30(18):2999-3000.
[16] 赖娟, 杜立中, 熊国强, 等. 1108例新生儿呼吸衰竭的临床流行病学特征[J]. 中国当代儿科杂志, 2016, 18(1):10-14.
