Li Yan-Hua, Wang Xin-Li
Department of Pediatrics, Peking University Third Hospital, Beijing, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Apr;15(4):254-8.
To investigate risk factors for parenteral nutrition-associated cholestasis (PNAC) in preterm infants.
A retrospective case-control study was performed on 244 preterm infants who received parenteral nutrition (PN) for over 14 days from January 2000 to October 2011.
Compared with those without PNAC (n=221), preterm infants with PNAC (n=23) had a longer total duration of PN, a higher total amino acid intake, a higher total lipid intake, a higher maximum daily amino acid intake, a higher maximum daily lipid intake, a higher intravenous calorie intake on the 14th day of PN, a lower birth weight and higher incidence rates of neonatal infection and anemia. Compared with those with PNAC, preterm infants without PNAC who showed a higher total amino acid intake also had a higher total lipid intake, a longer total duration of PN, a higher rate of mechanical ventilation and a lower gestational age. The preterm infants without PNAC who showed a higher total lipid intake also had a lower gestational age. Preterm infants without PNAC who showed a longer total duration of PN also had a lower gestational age.
Total duration of PN, total amino acid intake, maximum daily amino acid intake, total lipid intake, maximum daily lipid intake, intravenous calorie intake on the 14th day of PN, low birth weight, and neonatal infection and anemia are the risk factors for PNAC. Other risk factors need further investigation.
探讨早产儿肠外营养相关胆汁淤积(PNAC)的危险因素。
对2000年1月至2011年10月期间接受肠外营养(PN)超过14天的244例早产儿进行回顾性病例对照研究。
与未发生PNAC的早产儿(n = 221)相比,发生PNAC的早产儿(n = 23)PN总疗程更长、总氨基酸摄入量更高、总脂肪摄入量更高、每日最大氨基酸摄入量更高、每日最大脂肪摄入量更高、PN第14天静脉热量摄入量更高、出生体重更低,新生儿感染和贫血发生率更高。与发生PNAC的早产儿相比,总氨基酸摄入量较高但未发生PNAC的早产儿总脂肪摄入量也更高、PN总疗程更长、机械通气率更高且胎龄更小。总脂肪摄入量较高但未发生PNAC的早产儿胎龄也更小。PN总疗程较长但未发生PNAC的早产儿胎龄也更小。
PN总疗程、总氨基酸摄入量、每日最大氨基酸摄入量、总脂肪摄入量、每日最大脂肪摄入量、PN第14天静脉热量摄入量、低出生体重以及新生儿感染和贫血是PNAC的危险因素。其他危险因素有待进一步研究。