Department of Neonatalogy, University of Health Sciences, Kayseri City Hospital, Turkey.
Department of Pediatric Endocrinology, Memorial Kayseri Hospital, Kayseri, Turkey.
Niger J Clin Pract. 2023 Sep;26(9):1226-1233. doi: 10.4103/njcp.njcp_216_22.
BACKGROUND/AIM: Prolonged jaundice is one of the most common problems during neonatal period. The aim of this study was to evaluate the efficiency of ursodeoxycholic acid (UDCA) treatment in newborn infants with prolonged unconjugated hyperbilirubinemia.
The present study included 27 patients who were fed by breast milk and followed up in the outpatient clinic due to prolonged jaundice without any underlying etiological factor; 10 mg/kg/day UDCA was administrated in two doses for 7 days. Furthermore, 20 newborns diagnosed with prolonged jaundice with same characteristics were enrolled as the control group. The control group was also given a placebo; demographic characteristics, liver functions tests before and after the treatment, bilirubin decrease rates, and hemogram parameters of groups were compared.
Total bilirubin levels in the study and control groups before the treatment were 16.02 ± 1.41 mg/dL and 15.93 ± 1.66 mg/dL, respectively (P = 0.84). Total bilirubin levels in the study and control groups at day 7 after UDCA treatment were detected 8.18 ± 2.31 mg/dL and 13.92 ± 2.66 mg/dL, respectively (P < 0.001), and at day 14 after the treatment were 5.45 ± 2.59 mg/dL and 11.91 ± 2.83 mg/dL, respectively (P < 0.001). Furthermore, serum aspartate aminotransferase (AST) was detected <21 U/L in the ROC analysis after UDCA treatment (P = 0.04).
The study outcomes indicated that an efficient reduction in total bilirubin levels may be achieved, and outpatient clinic follow-up period may be reduced in patients whom UDCA was administrated. Moreover, it may be speculated that AST can be used to evaluate the efficacy after treatment. However, studies with larger sample sizes are needed for the routine use of UDCA in the treatment of prolonged jaundice.
背景/目的：迁延性黄疸是新生儿期最常见的问题之一。本研究旨在评估熊去氧胆酸（UDCA）治疗新生儿迁延性未结合高胆红素血症的疗效。
本研究纳入了 27 名因无潜在病因的迁延性黄疸而母乳喂养并在门诊随访的患者；给予 UDCA 10mg/kg/天，分两次给药，共 7 天。此外，还纳入了 20 名具有相同特征的诊断为迁延性黄疸的新生儿作为对照组。对照组给予安慰剂；比较了各组的人口统计学特征、治疗前后肝功能检查、胆红素下降率和血常规参数。
治疗前研究组和对照组总胆红素水平分别为 16.02±1.41mg/dL 和 15.93±1.66mg/dL（P=0.84）。治疗后第 7 天，研究组和对照组总胆红素水平分别为 8.18±2.31mg/dL 和 13.92±2.66mg/dL（P<0.001），治疗后第 14 天分别为 5.45±2.59mg/dL 和 11.91±2.83mg/dL（P<0.001）。此外，ROC 分析显示 UDCA 治疗后血清天门冬氨酸氨基转移酶（AST）<21U/L（P=0.04）。
研究结果表明，UDCA 治疗可有效降低总胆红素水平，缩短门诊随访时间。此外，AST 可能可用于评估治疗后的疗效。然而，需要更大样本量的研究来确定 UDCA 治疗迁延性黄疸的常规应用。
