【摘要】 目的观察还原型谷胱甘肽预防早产儿发生胃肠外营养相关性胆汁淤积(PNAC)的临床疗效。方法选择胎龄30~34周的早产儿70例,随机分为对照组和干预组,每组35例,两组患儿出生后24 h内均接受静脉营养和相同的基础治疗,干预组从胃肠内喂养开始即给予还原型谷胱甘肽口服,14 d后观察两组患儿血液生化指标[天门冬氨酸氨基转移酶(AST)﹑丙氨酸氨基转移酶(ALT)﹑总胆红素(TB)﹑结合胆红素(CB)﹑总胆汁酸(TAB)和γ-谷氨酰转肽酶(γ-GGT)]的变化差异及PNAC的发生率,并检测两组患儿发生PNAC的相关因素[全胃肠外营养(TPN)时间﹑量,胎龄和体质量]有无差异。结果治疗2周后,干预组患儿的血液生化指标AST﹑ALT﹑TB﹑CB﹑TAB和γ-GGT以及PNAC发生率明显低于对照组,差异有统计学意义(P<0.05);两组患儿PNAC发生的相关因素(TPN时间﹑量,胎龄和体质量)比较,差异均无统计学意义(P>0.05)。结论还原型谷胱甘肽能有效预防早产儿PNAC的发生。更多还原

【Abstract】 Objective To observe the clinical efficacy of reduced glutathione to prevent the occurrence of parenteral nutrition associated cholestasi(PNAC) in premature infants.Methods Totally 70 premature infants aged 30-34 weeks were selected and randomly divided into the intervention group and the control group,35 cases in each group.Within 24 hours after birth,the infants in both groups received intravenous nutrition and the same basic treatment,meanwhile,the intervention group was given reduced glutathione from enteral orally.After 14 days,the change and occurrence rate of PNAC in the two groups were observed on blood biochemical indicators [aspartate amino transferase(AST),alanine aminotransferase(ALT),unconjugated bilirubin(UCB),conjugated bilirubin(CB),total bile acid(TAB) and γ-glutamyltranspeptidase(γ-GGT) ],and to examine the difference between the two groups on the relevant factors(TPN time,TPN quantity,gestational age and body mass) with PNAC.Results After two weeks,the serum biochemical indictors(AST,ALT,TB,CB,TAB and γ-GGT) and the occurrence rate of PNAC in the intervention group were significantly lower than those in the control group with statistically significant difference(P<0.05).There was no statistical significant difference between the two groups on the relevant factors with PNAC(TPN time,TPN weight,gestational age and body mass)(P>0.05).Conclusion Reduced glutathione can prevent the occurrence of PNAC on premature infants effectively.更多还原