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多种油脂肪乳与中/长链脂肪乳对极低出生体重早产儿肠外营养相关性肝病、肝功能及血脂指标影响的对比研究
Effects of multi-oil fat emulsion and medium/long-chain fat emulsion on parenteral nutrition-associated liver disease, liver function, and blood lipid indicators in very low birth weight premature infants: a comparative study

内科 页码:499-503

作者机构:郑州大学第三附属医院/河南省妇幼保健院 1 药学部,2 产科,河南省郑州市 450052

DOI:10.16121/j.cnki.cn45-1347/r.2025.05.07

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  • 英文简介
  • 参考文献

目的 分析并比较多种油脂肪乳与中/长链脂肪乳对极低出生体重早产儿肠外营养相关性肝病(PNALD)、肝功能及血脂指标的影响。方法 回顾性选取80例需长期肠外营养支持(>2周)的极低出生体重早产儿作为研究对象,根据所用脂肪乳类型将其分为多种油脂肪乳组(n=40)与中/长链脂肪乳组(n=40)。比较两组早产儿的PNALD发生率、肝功能指标[包括总胆红素(TBil)、直接胆红素(DBil)、总胆汁酸(TBA)、γ-谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(Alb)]及血脂指标[包括总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]。结果 多种油脂肪乳组PNALD发生率(0.00%)低于中/长链脂肪乳组(15.00%)(P<0.05)。多种油脂肪乳组血清TBil、DBil、TBA、GGT、ALP、ALT及AST水平均低于中/长链脂肪乳组,血清Alb水平高于中/长链脂肪乳组(均P<0.05)。多种油脂肪乳组血清总胆固醇、甘油三酯及LDL-C水平均低于中/长链脂肪乳组,血清HDL-C水平高于中/长链脂肪乳组(均P<0.05)。结论 与中/长链脂肪乳相比,在极低出生体重早产儿肠外营养中应用多种油脂肪乳或可降低PNALD发生率,并改善肝功能及血脂指标。

Objective To analyze and compare the effects of multi-oil fat emulsion and medium/long-chain fat emulsion on parenteral nutrition-associated liver disease (PNALD), liver function, and blood lipid indicators in very low birth weight premature infants. Methods A total of 80 very low birth weight premature infants who required long-term parenteral nutrition support (>2 weeks) were retrospectively selected, and they were divided into either a multi-oil fat emulsion group (n=40) or a medium/long-chain fat emulsion group (n=40) according to the type of fat emulsion used. The incidence of PNALD, liver function indicators (including total bilirubin [TBil], direct bilirubin [DBil], total bile acid [TBA], γ-glutamyl transferase [GGT], alkaline phosphatase [ALP], alanine aminotransferase [ALT], aspartate aminotransferase [AST], and albumin [Alb]), and blood lipid indicators (including total cholesterol, triglycerides, low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) were compared between the two groups of premature infants. Results The incidence of PNALD in the multi-oil fat emulsion group (0.00%) was lower than that in the medium/long-chain fat emulsion group (15.00%) (P<0.05). The serum levels of TBil, DBil, TBA, GGT, ALP, ALT, and AST in the multi-oil fat emulsion group were all lower than those in the medium/long-chain fat emulsion group, while the serum Alb level was higher than that in the medium/long-chain fat emulsion group (all P<0.05). The serum levels of total cholesterol, triglycerides, and LDL-C in the multi-oil fat emulsion group were all lower than those in the medium/long-chain fat emulsion group, and the serum HDL-C level was higher than that in the medium/long-chain fat emulsion group (all P<0.05). Conclusion Compared with medium/long-chain fat emulsion, the application of multi-oil fat emulsion in parenteral nutrition for very low birth weight premature infants may reduce the incidence of PNALD and improve liver function and blood lipid indicators.

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