多种油脂肪乳剂对超未成熟儿肝功能影响

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。

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

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 of γ-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.