早产儿血清总胆汁酸升高的危险因素分析

Risk factors for elevated serum total bile acid in preterm infants

摘要:

目的 探讨早产儿血清总胆汁酸（TBA）升高的危险因素。方法 回顾性分析入住新生儿重症监护病房的216例早产儿的临床资料。以是否发生TBA升高（TBA > 24.8 μmol/L），将早产儿分为TBA升高组（53例）和非TBA升高组（163例）。对可能导致TBA升高的影响因素进行单因素分析和非条件多因素logistic回归分析。结果 单因素分析显示，TBA升高和非TBA升高两组出生胎龄、出生体重、小于胎龄儿比例、呼吸机辅助通气比例、禁食时间、静脉营养时间以及新生儿呼吸衰竭、新生儿败血症的发生率的比较差异有统计学意义（P < 0.05）。非条件多因素logistic回归分析显示，低出生体重（OR=3.84，95% CI：1.53~9.64）、新生儿败血症（OR=2.56，95% CI：1.01~6.47）是早产儿TBA升高的独立危险因素。结论 低出生体重及新生儿败血症可导致TBA升高。

Abstract:

Objective To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. Methods A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA > 24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. Results The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (P < 0.05). The unconditional multivariate logistic regression analysis showed that low birth weight (OR=3.84, 95% CI:1.53-9.64) and neonatal sepsis (OR=2.56, 95% CI:1.01-6.47) were independent risk factors for elevated TBA in preterm infants. Conclusions Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.