中/长链脂肪乳及长链脂肪乳对早产儿静脉营养性胆汁淤积的影响

中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (10): 1167-1171.

中/长链脂肪乳及长链脂肪乳对早产儿静脉营养性胆汁淤积的影响

蔡瑞宏¹，杨长仪²，修文龙²，蔡文红²，林云峰²

¹福建省妇幼保健院药剂科临床药学室，²福建省妇幼保健院新生儿科，福州 350001，福建

收稿日期:2017-03-17 修回日期:2017-09-06 出版日期:2017-10-26 发布日期:2017-11-13
作者简介:蔡瑞宏，女，硕士研究生，主管药师，研究方向：临床药学。 Tel:13799344498 E-mail:girlcrhong@163.com

Effects of MCT/LCT and LCT fatty acid on parenteral nutrition-associated cholestasis in premature infants

CAI Ruihong¹, YANG Changyi ², XIU Wenlong ², CAI Wenhong ², LIN Yunfeng ²

¹Clinical Pharmaceutics Room, Department of Pharmacy; ² Neonatology Department, Fujian Maternity and Children Health Hospital, Fuzhou 350001, Fujian, China

Received:2017-03-17 Revised:2017-09-06 Online:2017-10-26 Published:2017-11-13

摘要/Abstract

摘要：

目的: 探讨中/长链脂肪乳和长链脂肪乳对接受长期静脉营养早产儿胆汁淤积（PNAC）发生率的影响，为新生儿静脉营养脂肪乳的选择提供参考，并探讨静脉营养相关性胆汁淤积的保护因素。方法: 采用回顾性病例对照研究，收集2015年3月和2016年3月入住福建省妇幼保健院新生儿重症监护室，静脉营养时间超过14 d、胎龄29~34周患儿相关数据，两个时间段采用不同类型脂肪乳，对比两组患儿胆汁淤积的发生情况；收集2016年3月至9月相同条件患儿数据，根据长链脂肪乳日最大剂量分为≥3 g·kg^-1·d^-1组和≤2 g·kg^-1·d^-1组，对比二者胆汁淤积发生情况。结果: 长链脂肪乳患儿PNAC发生率更高，差异有统计学意义；脂乳日最大剂量≥3 g·kg^-1·d^-1组PNAC发生率更高，且达全胃肠营养时间更长，脂肪乳累积用量更高，住院时间更长。结论: 长链脂肪乳更易导致胆汁淤积，减少脂肪乳的累积用量和日最大剂量，尽快实现全胃肠营养是静脉营养性胆汁淤积的保护因素。

关键词: 中/长链脂肪乳, 长链脂肪乳, 静脉营养性胆汁淤积, 日最大剂量

Abstract:

AIM: To investigate the effect of MCT/LCT and LCT fat emulsion on the incidence of parenteral nutrition-associated cholestasis (PNAC) in preterm infants that accept long-term parenteral nutrition (PN) so as to provide a reference for the choice of neonatal PN fat emulsion, and to explore the protective factors of PNAC. METHODS: This retrospective analysis was conducted on hospitalization data of preterm infants (gestational age 29-34 weeks) that received PN for more than 14 days in March 2015 and March 2016 in NICU. Different types of fat emulsion were used in these two periods; the occurrence of PNAC was compared. Then the patients with the same condition were collected from March 2016 to September 2016, and these patients were divided into two groups (≥3 g·kg-1·d-1 group and ≤2 g·kg-1·d-1 group) according to the daily maximum dosage of LCT fat emulsion. The occurrence of cholestasis was compared in the two groups.RESULTS:Compared with MCT/LCT, the incidence of PNAC was significantly increased in LCT group.The patients that received ≥3 g·kg-1·d-1 daily maximum dosage of LCT has a higher incidence of PNAC and lipid accumulative amount; and the time to reach the whole gastrointestinal nutrition was longer as well as the hospital stay. CONCLUSION: LCT is more likely to cause cholestasis. Reducing the accumulative amount of fat emulsion and daily maximum dosage, achieving total gastrointestinal nutrition as soon as possible are protective factors of PNAC.

Key words: MCT/LCT, LCT, parenteral nutrition-associated cholestasis, daily maximum dose

中图分类号:

R722

蔡瑞宏，杨长仪，修文龙，蔡文红，林云峰. 中/长链脂肪乳及长链脂肪乳对早产儿静脉营养性胆汁淤积的影响[J]. 中国临床药理学与治疗学, 2017, 22(10): 1167-1171.

CAI Ruihong, YANG Changyi, XIU Wenlong, CAI Wenhong, LIN Yunfeng. Effects of MCT/LCT and LCT fatty acid on parenteral nutrition-associated cholestasis in premature infants[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(10): 1167-1171.

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