胆道闭锁患儿微量营养素缺乏及防治研究进展

doi:10.11852/zgetbjzz2019-1784

中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (1): 60-62.DOI: 10.11852/zgetbjzz2019-1784

胆道闭锁患儿微量营养素缺乏及防治研究进展

鲜若凌, 胡燕, 李英存

重庆医科大学附属儿童医院儿童保健科、肝胆外科;儿童发育疾病研究教育部重点实验室;国家儿童健康与疾病医学研究中心;儿童发育重大疾病国家国际科技合作基地;儿童营养与健康重庆市重点实验室,重庆 400014

收稿日期:2019-11-23 修回日期:2020-02-15 发布日期:2021-01-10 出版日期:2021-01-10
通讯作者: 李英存,E-maillyc@163.com
作者简介:鲜若凌(1995-),女,重庆人,住院医师,在读研究生,主要研究方向为儿童保健方向。
基金资助:
重庆市科委社会民生面上项目(cstc2018jscx-msyb0058)

Progress on the treatment and prevention of micronutrient deficiency in children with biliary atresia

XIAN Ruo-ling, HU Yan, LI Ying-cun

Department of Child Health Care and Hepto-biliary Surgery;Ministry of Education Key Laboratory of Child Development and Disorders;National Clinical Research Center for Child Health and Disorders;China International Science and Technology Cooperation Base of Child Development and Critical Disorders;Chongqing Key Laboratory of Child Health and Nutrition;Children's Hospital of Chongqing Medical University,Chongqing 400014,China

Received:2019-11-23 Revised:2020-02-15 Online:2021-01-10 Published:2021-01-10
Contact: LI Ying-cun,E-mail:lyc@163.com

摘要/Abstract

摘要： 胆道闭锁是新生儿胆汁淤积的常见原因,也是儿童肝移植最主要的原发病,若不及时治疗,预后不良。而因胆道梗阻,导致消化吸收及代谢等多方面障碍,此类患儿常伴有营养不良,其中微量营养素,特别是脂溶性维生素的缺乏不仅会导致病情加重,还可能并发其他临床症状。本文通过查阅相关文献,就胆道闭锁患儿的微量营养素缺乏现状、相关机制及支持方案等进行综述,为临床改善患儿营养状况及预后提供参考和帮助。

关键词: 胆道闭锁, 营养不良, 微量营养素

Abstract: Biliary atresia (BA) is a common cause for cholestasis in neonates and is also the main disease for liver transplantation in children.Poor prognosis may occur for delayed treatment.Patients may accompany with malnutrition due to negative effect on digestion,absorption,metabolism caused by biliary obstruction.The lack of micronutrients,especially fat-soluble vitamins,may not only lead to the aggravation of the disease,but also cause other clinical symptoms.Therefore,this paper reviews the status,mechanisms,treatment and prevention of micronutrient deficiency in children with BA,thus to provide support for improvement of nutritional status and prognosis of these children.

Key words: biliary atresia, malnutrition, micronutrient

中图分类号:

R722.1

鲜若凌, 胡燕, 李英存. 胆道闭锁患儿微量营养素缺乏及防治研究进展[J]. 中国儿童保健杂志, 2021, 29(1): 60-62.

XIAN Ruo-ling, HU Yan, LI Ying-cun. Progress on the treatment and prevention of micronutrient deficiency in children with biliary atresia[J]. journal1, 2021, 29(1): 60-62.

参考文献

[1] Nizery L,Chardot C,Sissaoui S,et al.Biliary atresia:clinical advances and perspectives[J].Clin Res Hepatol Gastroenterol,2016,40(3):281-287.
[2] 李海波,符洪源,陆桐宇,等.肝移植领域2017年度重要进展盘点[J].器官移植,2018,9(1):41-50,82.
[3] Young S,Kwarta E,Azzam R,et al.Nutrition assessment and support in children with end-stage liver disease[J].Nutr Clin Pract,2013,28(3):317-329.
[4] Karakoyun M,Baran M,Turan C,et al.Infants with extrahepatic biliary atresia:effect of follow-up on the survival rate at Ege University Medical School transplantation center[J].Turk J Gastroenterol,2017,28(4):298-302.
[5] Saron ML,Godoy HT,Hessel G.Nutritional status of patients with biliary atresia and autoimmune hepatitis related to serum levels of vitamins A,D and E[J].Arq Gastroenterol,2009,46(1):62-68.
[6] Dong R,Sun S,Liu XZ,et al.Fat-soluble vitamin deficiency in pediatric patients with biliary atresia[J].Gastroenterol Res Pract,2017,2017:7496860.
[7] Shen YM,Wu JF,Hsu HY,et al.Oral absorbable fat-soluble vitamin formulation in pediatric patients with cholestasis[J].J Pediatr Gastroenterol Nutr,2012.55(5):587-591.
[8] 阎雪,韩笑,张会丰.2016版“营养性佝偻病防治全球共识”解读[J].中华儿科杂志,2016,54(12):891-895.
[9] Venkat VL,Shneider BL,Magee JC,et al.Total serum bilirubin predicts fat-soluble vitamin deficiency better than serum bile acids in infants with biliary atresia[J].J Pediatr Gastroenterol Nutr,2014,59(6):702-707.
[10] 王少亭,乐娟,袁腾飞,等.新生儿血清25羟基维生素D与新生儿黄疸的关系[J/OL].中国现代医学杂志,2019:1-9.[2020-06-04].http://kns.cnki.net/kcms/detail/43125R.20190905.1052.006.html.
[11] Peng CH,Lee HC,Jiang CB,et al.Serum vitamin D level is inversely associated with liver fibrosis in post Kasai's portoenterostomy biliary atresia patients living with native liver[J].PLoS One,2019,14(6):e0218896.
[12] Ng J,Paul A,Wright N,et al.Vitamin D levels in infants with biliary atresia:pre- and post-kasai portoenterostomy[J].J Pediatr Gastroenterol Nutr,2016,62(5):746-750.
[13] Jensen M,Abu-El-Haija M,Bishop W,et al.Difficulty achieving vitamin D sufficiency with high-dose oral repletion therapy in infants with cholestasis[J].J Pediatr Gastroenterol Nutr,2015,61(2):187-189.
[14] 李廷玉,黄鸿眉.维生素A缺乏的诊断、治疗及预防[J].实用儿科临床杂志,2010,25(11):867-868.
[15] Yeh YT,Lin NC,Yeh YC,et al.Vitamin A can ameliorate fibrosis of liver in an established rat model of biliary atresia and Kasai portoenterostomy[J].J Pediatr Surg,2018,53(12):2416-2422.
[16] 史志振.表现为维生素K缺乏症的先天性胆道畸形8例报告[J].现代实用医学,2009,21(7):770.
[17] 魏中南,詹江华,张庆江,等.胆道闭锁以晚发性维生素K缺乏性颅内出血为首发症状的临床诊疗体会[J].天津医药,2016,44(7):814-816.
[18] Strople J,Lovell G,Heubi J.Prevalence of subclinical vitamin K deficiency in cholestatic liver disease[J].J Pediatr Gastroenterol Nutr,2009,49(1):78-84.
[19] Witt M,Kvist N,Jørgensen MH,et al.Prophylactic dosing of vitamin K to prevent bleeding[J].Pediatrics,2016,137(5).pii:e2015422.
[20] Kramer RA,Zemel BS,Arvay-Nezu JL,et al.Bone health in a nonjaundiced population of children with biliary atresia[J].Gastroenterol Res Pract,2009,2009:387029.
[21] Raphael BP.Nutritional management in cholestatic liver disease[J].World Rev Nutr Diet,2015,113:178-181.
[22] El-Koofy N,Fouad HM,Fahmy ME,et al.Copper concentrations in Egyptian infants with cholestasis:a single center study[J].Arab J Gastroenterol,2018,19(1):21-25.
[23] Blackmer AB,Bailey E.Management of copper deficiency in cholestatic infants:review of the literature and a case series[J].Nutr Clin Pract,2013,28(1):75-86.
[24] 卫园园,詹江华.胆道闭锁流行病学研究进展[J].天津医科大学学报,2017,23(5):480-482.

胆道闭锁患儿微量营养素缺乏及防治研究进展

Progress on the treatment and prevention of micronutrient deficiency in children with biliary atresia

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	尹莉梅, 王燕玲, 朱小南, 郑菁, 曹永琴, 孙玮, 费秀兰, 陈国华. 甘肃省临夏州农村10～12岁学龄儿童营养与体格发育状况调查[J]. 中国儿童保健杂志, 2023, 31(2): 215-219.
[2]	杨晓尘, 何辉, 云青萍, 李一辰, 常春. 北京市学龄前儿童2000—2020年营养不良及超重肥胖趋势研究[J]. 中国儿童保健杂志, 2023, 31(1): 21-26.
[3]	施磊, 童光磊, 李红, 陈婧, 吴杉杉. 脑性瘫痪儿童喂养/吞咽困难和营养不良筛查工具的临床应用[J]. 中国儿童保健杂志, 2022, 30(9): 1024-1028.
[4]	方亮, 黄永玲, 计国平, 吴曙东. 安徽省贫困地区2015—2020年婴幼儿营养状况监测结果分析[J]. 中国儿童保健杂志, 2022, 30(5): 500-503.
[5]	陈土容, 黄美欢, 曹建国. 杜氏肌营养不良儿童的运动功能与全身力量、年龄的相关性研究[J]. 中国儿童保健杂志, 2022, 30(3): 264-267.
[6]	陈婧, 童光磊, 施磊, 叶福玲, 冯超, 徐学翠, 李红. 脑瘫儿童主观全面营养评估方法的临床研究[J]. 中国儿童保健杂志, 2022, 30(2): 212-215.
[7]	吴薇岚, 江蕙芸, 罗宇阳, 朱才荣, 刘昕, 蒙晓梅. 家庭喂养方式和父母负性情绪与儿童营养不良发生的相关性[J]. 中国儿童保健杂志, 2022, 30(1): 25-29.
[8]	肖述月, 姚诗忆, 马忠华, 熊梅, 彭竞, 徐韬. 四川省凉山州4个重点贫困县6~24月龄婴幼儿营养及喂养现状调查[J]. 中国儿童保健杂志, 2021, 29(2): 138-142.
[9]	郑蓉, 梁芳, 白瑾, 潘丽, 白清丽, 李芝兰. 兰州市2000-2018年5岁以下儿童营养性疾病患病分析[J]. 中国儿童保健杂志, 2021, 29(2): 198-201.
[10]	赵晓鹏, 谢颖, 胡环宇, 赵丽华, 陈银红, 李增宁. 生物电阻抗法与体重指数在杜氏肌营养不良患儿营养评估中的比较研究[J]. 中国儿童保健杂志, 2020, 28(8): 917-920.
[11]	戴一鸣, 郭剑秋, 张济明, 肖洪喜, 邬春华, 周志俊. 学龄期儿童膳食多样化与微量营养素摄入量的关联性分析[J]. 中国儿童保健杂志, 2020, 28(2): 183-186.
[12]	石鑫淼, 王琳. 益生菌治疗儿童营养不良研究进展[J]. 中国儿童保健杂志, 2020, 28(10): 1118-1121.
[13]	高越, 崔素莘, 廖建军, 葛菲, 陈永慧. 新疆自治区贫困地区6～24月龄婴幼儿营养状况分析[J]. 中国儿童保健杂志, 2020, 28(10): 1148-1152.
[14]	翟淳, 史惟, 李惠, 李西华, 苏怡, 王燕娜, 陆恺. 6～11岁杜氏进行性肌营养不良儿童与正常儿童下肢肌力对照分析[J]. 中国儿童保健杂志, 2019, 27(8): 877-880.
[15]	刘德国, 刘德云, 王倩, 杨俐琦, 刘跃. 安徽省中小学生营养不良患病率调查[J]. 中国儿童保健杂志, 2019, 27(7): 793-796.