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TB、ALT、AST水平的影响

Curative effect of ursodeoxycholic acid in treatment of parenteral nutrition associated cholestasis in premature infants and the influence on the levels of serum TB,ALT,and AST

目的探讨采用熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症(PNAC)的临床疗效及对血清总胆红素(TB)、丙氨酸氨基转移酶(ALT)及天门冬氨酸氨基转移酶(AST)水平的影响,旨在为临床治疗PNAC提供参考。方法选取2016年5月-2017年5月该院收治的102例早产儿PNAC患儿为研究对象,随机分为观察组和对照组,每组各51例。对照组给予常规对症治疗,观察组加以熊去氧胆酸胶囊治疗,对比两组的临床疗效、治疗前后肝功能指标改善情况,并统计两组不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05);两组治疗前肝功能指标水平比较差异无统计学意义(P>0.05),两组治疗后的血清TB、ALT、AST水平均显著下降(P<0.05),且观察组低于对照组(P<0.05);两组患儿不良反应主要表现为食欲不振、腹泻和皮疹,反应轻微,患儿均可耐受。结论对于PNAC早产患儿,在常规治疗基础上加以熊去氧胆酸治疗可显著提高临床疗效,改善患儿肝功能,且无明显副作用。

Objective To explore the curative effect of ursodeoxycholic acid in treatment of parenteral nutrition associated cholestasis（ PNAC） in premature infants and the influence on the levels of serum total bilirubin（ TB）,alanine aminotransferase（ ALT）,and aspartate aminotransferase（ AST）,provide a reference for clinical treatment of PNAC. Methods From May 2016 to May 2017,102 premature infants with PNAC treated in the Fourth Hospital of Xi＇an were selected and randomly divided into observation group and control group,51 premature infants in each group. The premature infants in control group were treated by conventional symptomatic treatment,and the premature infants in observation group were treated by conventional symptomatic treatment and ursodeoxycholic acid. The clinical efficacies and improvements of liver function indexes before and after treatment,the incidence rates of adverse reactions in the two groups were compared.Results The total effective rate in observation group was statistically significantly higher than that in control group（ P〈0. 05）. There was no statistically significant difference in liver function indexes before treatment between the two groups（ P〈0. 05）. In the two groups,the levels of serum TB,ALT,and AST after treatment decreased significantly（ P〈0. 05）. The levels of serum TB,ALT,and AST after treatment in observation group were statistically significantly lower than those in control group（ P〈0. 05）. The main manifestations of adverse reactions in the two groups included anorexia,diarrhea,and rash,the adverse reactions were mild,which were tolerated by the premature infants. Conclusion Based on routine treatment,ursodeoxycholic acid can significantly improve clinical efficacy and liver function of premature infants with PNAC,no obvious adverse reaction is found.