多种油脂肪乳剂对超未成熟儿肝功能影响

Effects of multi-oil fat emulsions on liver function in extremely immature infants

目的:探讨多种油脂肪乳剂对超未成熟儿肝脏功能的影响。方法:回顾分析2015年7月1日至2021年6月30日收治的胎龄<28周、接受肠外静脉营养超过2周的超未成熟儿60例。根据应用脂肪乳剂种类不同,分为SMOF(多种油脂肪乳)组(n=30),和LCT(长链脂肪乳)组(n=30)。比较2组DBIL、ALT、γ-GT、TBA达峰值的指标及胃肠外营养相关性胆汁淤积(PNAC)发病率。结果:LCT组DBIL、ALT、γ-GT、TBA峰值均数分别为25.7(6.5~223)μmol·L^(-1)、(52.5±44.7)U·L^(-1)、(204.9±74.7)U·L^(-1)、(64.9±48.6)μmol·L^(-1),SMOF组DBIL、ALT、γ-GT、TBA峰值均数分别为15.1(5.2~167.7)μmol·L^(-1)、(32.5±18.8)U·L^(-1)、(176.9±74.7)U·L^(-1)、(53.3±35.8)μmol·L^(-1),其中2组DBIL、ALT峰值比较,P分别为0.026及0.034,差异均有统计学意义。2组γ-GT、TBA峰值比较差异无统计学意义。LCT组PNAC发生率为40%,SMOF组PNAC发生率为16.7%,2组比较差异有统计学意义(P=0.042)。结论:与LCT比较,SMOF能减轻超未成熟儿DBIL、GOT、γ-GT、TBA的严重程度,并降低PNAC的发生率,对肝脏有一定的保护作用。

OBJECTIVE To investigate the effects of multi-oil fat emulsions on liver function in extremely immature infants.METHODS A retrospective analysis was conducted on 60 extremely immature infants with the gestational age lower than 28 weeks received parenteral nutrition for more than 2 weeks from July 1,2015 to June 30,2021.According to different types of fat emulsions,they were divided into SMOF(multi-oil fat emulsion)group(n=30)and LCT(long chain fat emulsion)group(n=30).Indexes including peak values of DBIL,ALT,γ-GT amd TBA,and the incidence of PNAC(parenteral nutrition associated cholestasis)were compared between the two groups.RESULTS The averaged peak values of DBIL,ALT,γ-GT,and TBA in the LCT group were 25.7(6.5-223)μmol·L^(-1),(52.5±44.7)U·L^(-1),(204.9±74.7)U·L^(-1)and(64.9±48.6)μmol·L^(-1),respectively.While the averaged peak values of DBIL,ALT,γ-GT,and TBA in the SMOF group were 15.1(5.2-167.7)μmol·L^(-1),(32.5±18.8)U·L^(-1),(176.9±74.7)U·L^(-1)and(53.3±35.8)μmol·L^(-1),respectively.P-values of peaked DBIL and ALT were 0.026 and 0.034,respectively,suggesting the differences were statistically significant.There was no statistically significant difference in the peak values ofγ-GT and TBA between the two groups.The incidence of PNAC in the LCT group was 40%,and that in the SMOF group was 16.7%,suggesting the difference between the two groups was statistically significant(P=0.042).CONCLUSION Compared with LCT,SMOF reduces the severity of DBIL,GOT,γ-GT and TBA in extremely immature infants,and lowers the incidence of PNAC,which exhibits a protective effect on liver.