新生儿感染相关性胆汁淤积症血清内毒素检测及其临床意义

Determination of serum endotoxin level in neonates with sepsis-associated cholestasis and its clinical significance

目的:分析感染相关性胆汁淤积症新生儿患儿血清内毒素水平及临床意义。方法:对42例诊断为感染相关性胆汁淤积症的新生儿进行内毒素测定,比较治疗前及病情好转后血清内毒素水平变化情况;同时以30例明确存在感染但未出现胆汁淤积的新生儿作为对照组,比较两组之间内毒素水平差异。结果:胆汁淤积症患儿治疗前血清内毒素水平为(28.25±9.08)pg/ml,明显高于对照组(9.33±2.05)pg/ml,(P<0.05),而治疗好转后血清内毒素水平为(10.32±3.21)pg/ml,明显低于治疗前(P<0.05)。血清内毒素水平与肝功能指标间呈线性关系,回归系数具有统计学意义(P<0.05)。早产儿及低出生体重儿更容易出现感染相关性胆汁淤积症。结论:内毒素是导致新生儿感染相关性胆汁淤积的重要因素之一。进行抗内毒素治疗,可以缩短病程改善预后,具有重要的临床意义。

Objective： To analyze the level of serum endotoxin in neonates with sepsis-associated cholestasis and its clinical significance. Methods： In sepsis-associated eholestasis newborns, the level of serum endotoxin were detected before and after treatment. Meanwile, 30 clinical infection newborns without eholestasis were included in control group. Compared endotoxin level of two groups. Results ： The level of serum endotoxin in sepsis-associated cholestasis （ 28.25 ± 9. 08 ） pg/ml were significantly higher than control group （9. 33 ±2. 05 ） pg/ml before treatment （ P 〈 0. 05 ）, and gradually decreasing to （ 10. 32 ±3. 21 ） pg/ml （ P 〈 0. 05 ） after treatment. There was a linear relationship between the serum endotoxin level and index of liver function, the regression coefficient was statistically significant. Premature and low birth weight infants were more prone to sepsis-associated cholestasis. Conclusion： Endotoxin is one of the important factor to develop cholestasis in newborns with infection. To anti-endo- toxin can improve the prognosis and shorten the course of neonates.