Simić Dusica, Milojević Irina, Bogićević Dragana, Milenović Miodrag, Radlović Vladimir, Drasković Biljana, Benka Anna Uram, Sindjić Sanja, Maksimović Ruzica
Srp Arh Celok Lek. 2014 Mar-Apr;142(3-4):184-8. doi: 10.2298/sarh1404184s.
Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition.
The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA) use on cholestasis in newborns on prolonged TPN.
A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g) birth weight infants (n = 30), as well as the group of pediatric (n = 11) and surgical patients (n = 15) treated with UDCA. Blood chemistries were obtained two times weekly.
All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN) before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively).The peak serum conjugated bilirubin (CB), AST, ALT and alkaline phosphatase (AP) levels were significantly lower in the treated groups.There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups.There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group.
Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.
肠外营养相关胆汁淤积是接受长期肠外营养的足月儿和早产儿中一种广为人知的现象。
本研究旨在评估熊去氧胆酸（UDCA）对接受长期全胃肠外营养（TPN）的新生儿胆汁淤积的影响。
本回顾性研究共纳入56例婴儿：对照组包括低出生体重（1500g）婴儿（n = 30），以及接受UDCA治疗的儿科患者组（n = 11）和外科患者组（n = 15）。每周两次采集血液生化指标。
56例新生儿均发生胆汁淤积，但胆汁淤积发生前肠外营养（PN）的持续时间在接受UDCA治疗的患者中显著更长。对照组患者胆汁淤积发生前PN的平均持续时间为25天，而接受治疗的儿科和外科患者分别为39天和34天。治疗组血清结合胆红素（CB）、谷草转氨酶（AST）、谷丙转氨酶（ALT）和碱性磷酸酶（AP）的峰值水平显著更低。在考虑CB、ALT、AST和AP峰值时，接受治疗的儿科和外科患者之间以及低出生体重和高出生体重婴儿之间没有显著差异。所有治疗组胆汁淤积的持续时间均显著缩短。儿科和外科患者组在实现完全肠内营养所需时间上存在显著差异。
治疗组胆汁淤积的发生明显晚于对照组。UDCA在减轻胆汁淤积症状方面似乎非常成功。无法证实UDCA治疗在低出生体重和高出生体重婴儿之间疗效的差异。
