不同胎龄、不同出生体重新生儿的首次肝功能指标的差异性

  目的  探讨不同胎龄、不同出生体重新生儿的首次肝功能指标的差异变化。  方法  回顾性分析204例不同胎龄早产儿、206例不同出生体重儿的首次肝功能指标总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、总蛋白（TP）、白蛋白（ALB）、丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）、γ-谷氨酰基转移酶（GGT）、总胆汁酸（TBA）、前白蛋白（PA）、胆碱酯酶（CHE）的变化。比较分析各组中和组间生化指标的差异。  结果  不同胎龄、不同出生体重新生儿的首次肝功能指标存在差异:（1）晚期早产儿、中期早产儿、极早产儿中TP、ALB依次递减（P < 0.05）；CHE无统计学意义（P > 0.05）。晚期早产儿、中期早产儿的DBIL、GGT生成、排泄均比极早产儿好（P < 0.05）。（2）与正常出生体重儿比较，低出生体重儿仅TBA增高（P < 0.05）；与极低出生体重儿比较，正常出生体重儿、低出生体重儿DBIL、CHE增高，但仅有低出生体重儿DBIL具有统计学意义（P < 0.05）。  结论  不同胎龄、不同出生体重新生儿随胎龄越小、体重越轻，肝脏功能越差。胎龄对肝脏功能的影响，远大于体重对肝脏功能的影响。

Difference Analysis of First Liver Function Indexes of Newborns with Different Gestational Age and Birth Weight

  Objective   To study the difference in the first liver function indexes of newborns with different gestational ages and birth weights.   Methods  We retrospectively analyzed the the first liver function indexes including total bilirubin （TBIL）, direct bilirubin （DBIL）, indirect bilirubin （IBIL）, total protein （TP） , albumin （ALB）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, alkaline phosphatase （ALP）, g-glutamyltransferase （GGT）, total bile Changes in acid （TBA）, prealbumin （PA）, cholinesterase （CHE） of 204 premature infants with different gestational ages and 206 infants with different birth weights . Then we compared and analyzed the differences of each biochemical index in each group and between groups.  Results  There were differences in the first liver function indexes of newborns with different gestational ages and birth weights: （1） Late preterm infant group, mid-term preterm infant group and extremely preterm infant group, the levels of TP and ALB decreased sequentially with the decreasing gestational ages （P < 0.05）; the levels of CHE had no statistically significant difference （P > 0.05）. The levels of DBIL and GGT in late preterm infants and mid-term preterm infants were better than extremely premature infants （P < 0.05）. （2） Compared with normal birth weight infants, only TBA increased in low birth weight infants （P < 0.05）; Compared with very low birth weight infants, DBIL and CHE increased in normal birth weight and low birth weight infants, however, only DBIL in low birth weight infants was statistically significant （P < 0.05）.  Conclusions  For newborns with different gestational ages and birth weights, the younger the gestational age, the lighter the weight, the worse the liver function. The influence of gestational age on liver function is far greater than the influence of body weight on liver function.