熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的疗效及对患儿血清内毒素水平的影响

Effects of ursodeoxycholic acid on premature infants with parenteral nutrition associated cholestasis and on serum endotoxin level

目的:探讨熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的疗效及对患儿血清内毒素水平的影响。方法:选自2013年1月—2015年12月期间我院收治的胃肠外营养相关性胆汁淤积症早产儿64例,依据随机数字表法随机分为观察组32例与对照组32例。对照组采取常规对症治疗,观察组在对照组基础上结合熊去氧胆酸胶囊。两组疗程均为2周。比较两组患儿肝功能指标水平变化,以及不良反应发生情况。结果:两组血清TB、ALT、AST水平治疗前比较无统计学差异(P>0.05);两组血清TB、ALT、AST水平治疗后明显降低(P<0.05);观察组血清TB、ALT、AST水平治疗后低于对照组(P<0.05);两组血清内毒素水平治疗前比较无统计学差异(P>0.05);两组血清内毒素水平治疗后明显降低(P<0.05);观察组血清内毒素水平治疗后低于对照组(P<0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的效果明显,可明显改善患儿肝功能,降低血清内毒素水平,具有重要临床研究价值。

OBJECTIVE To investigate the effects of ursodeoxycholic acid on premature infants with parenteral nutrition associated cholestasis and influence on serum endotoxin level.METHODS From our hospital,64 premature infants with parenteral nutrition associated cholestasis were enrolled from January 2013 to December 2015,and randomly divided into observation group of 32 cases and control group of 32 cases.Patients received routine symptomatic treatment in control group,and ursodeoxycholic acid capules based on routine symptomatic treatment in observation group.The treatment was lsted for 2 weeks in two groups.The levels of liver function,serum endotoxin level,PNAC and adverse events were compared between the two groups.RESULTS After treatment,serum total bilirubin（TB）,glutamic-pyruvic transaminase（ALT）,glutamic-oxalacetic transaminase（AST）levels decreased（P〈0.05）in both groups,and serum TB,ALT and AST were obviously lower in observation group than in control group（P〈0.05）.Serum endotoxin decreased in both groups after treatment（P〉0.05）,particularly in observation group（P〈0.05）.No significant differnece was observed on rate of adverse drug reaction between two groups（P〉0.05）.CONCLUSION Ursodeoxycholic acid has obvious effects in premature infants with parenteral nutrition associated cholestasis,significantly improves liver function and reduce serum endotoxin level.