论文部分内容阅读
目的探讨S-腺苷蛋氨酸(SAMe)预防极低出生体重儿(VLBWI)胃肠外营养相关性胆汁瘀积症(PNAC)的防治作用。方法 2008年10月至2011年10月在本院应用胃肠外营养的VLBWI85例,随机分为对照组和观察组,观察组入院即开始应用SAMe(思美泰)0.1g/d,连用7d,两组患儿分别在日龄1d及14d时检测血清肝功能指标,对应用胃肠外营养14d以上者进行分析。结果对照组42例,发生胆汁淤积4例(9.5%),观察组43例,发生胆汁淤积2例(4.7%),两组差异有统计学意义(P<0.05)。对照组住院时间(29.7±4.6)d,血清TBA(96.7±14.6)μmol/L,DBil(48.9±4.4)μmol/L。ALP(298.3±30.7)U/L,观察组住院时间(21.3±3.5)d,血清TBA(43.7±9.2)μmol/L,DBil(20.1±4.9)μmol/L,ALP(187.9±39.4)U/L,两组差异均有统计学意义(P<0.05)。结论 SAMe可显著降低极低出生体重儿PNAC的发生率,减少住院天数,未观察到药物不良反应。防治VLBWIPNAC需采取综合措施。
Objective To investigate the preventive and therapeutic effects of S-adenosylmethionine (SAMe) on parenteral nutrition-associated cholestasis (PNAC) in very low birth weight infants (VLBWI). Methods From October 2008 to October 2011, 85 patients with VLBWI undergoing parenteral nutrition in our hospital were randomly divided into control group and observation group. SAMe (0.1mg / d) The serum liver function indexes of the two groups were detected on day 1 and day 14, respectively, and the parenteral nutrition for more than 14 days was analyzed. Results In the control group, 42 cases had cholestasis in 4 cases (9.5%), observation group (43 cases) and cholestasis in 2 cases (4.7%). There was significant difference between the two groups (P <0.05). The length of stay in the control group (29.7 ± 4.6) d, serum TBA (96.7 ± 14.6) μmol / L and DBil (48.9 ± 4.4) μmol / L respectively. ALP was 298.3 ± 30.7 U / L in the observation group, 21.3 ± 3.5 d in the observation group, 43.7 ± 9.2 μmol / L in the serum of TBA group, 20.1 ± 4.9 μmol / L in DBil group and 187.9 ± 39.4 U / L, the difference between the two groups was statistically significant (P <0.05). Conclusions SAMe can significantly reduce the incidence of PNAC in very low birth weight infants, reduce the length of stay, and no adverse drug reactions observed. Prevention and control VLBWIPNAC need to take comprehensive measures.