胆汁淤积性肝病患儿脂溶性维生素水平分析  

Analysis on fat-soluble vitamin level of infants with cholestatic hepatopathy

作　　者：唐爱群[1] 唐宇轩[1] 张德祥[1] 陈艳[1] 邓成清 Tang Aiqun;Tang Yuxuan;Zhang Dexiang;Chen Yan;Deng Chengqing(Department of Pediatric,Sheyang County People’s Hospital,Yancheng 224300,Jiangsu Province,China)

机构地区：[1]射阳县人民医院儿科,江苏盐城224300

出　　处：《中国肝脏病杂志（电子版）》2021年第3期48-55,共8页Chinese Journal of Liver Diseases：Electronic Version

摘　　要：目的分析婴儿胆汁淤积性肝病(infantile cholestatic hepatopathy,ICH)脂溶性维生素(fat-soluble vitamin,FSV)水平。方法选取2017年1月至2019年2月收治的42例ICH患儿为病例组,选取同期在本院出生的44例健康婴儿为对照组,根据孕妇孕后期及婴儿早期是否补充FSV,将病例组分为病例一组(18例)和病例二组(24例),其中病例一组孕妇孕后期及婴儿均未补充FSV,病例二组孕妇孕后期及婴儿均补充FSV,对照组根据以上标准分为对照一组(22例)和对照二组(22例)。采用随机数字表法将病例组分为母乳喂养组、人工喂养组和混合喂养组,每组14例。采用AU5811全自动生化分析仪检测肝功能指标,包括丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBil)、直接胆红素(direct bilirubin,DBil)、总胆汁酸(total bile acid,TBA)。采用血凝仪透射比浊测定法检测凝血功能,包括凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)。使用高效液相色谱串联质谱法进行血清FSV测定,包括维生素A、维生素D_(3)、维生素E、维生素K。两组间上述指标的比较采用独立样本t检验或秩和检验。FSV与ALT、AST、TBil和DBil的相关性采用Spearman秩相关分析。结果病例组和对照组婴儿年龄分别为(96.53±9.21)d和(93.84±8.67)d,差异无统计学意义(t=1.395,P=0.083)。病例组婴儿维生素A[(244.521±124.213)μg/L vs(380.705±133.289)μg/L]、维生素D_(3)[(17.459±6.399)μg/L vs(31.962±7.348)μg/L]、维生素E[(6.020±2.302)μg/L vs(18.735±4.326)μg/L]及维生素K[(10.945±3.447)μg/L vs(22.375±5.655)μg/L]水平均显著低于对照组,差异均有统计学意义(P均<0.05)。病例一组与病例二组婴儿维生素A[(242.155±106.981)μg/L vs(246.296±157.712)μg/L]、维生素D_(3)[(16.401±4.319)μg/L vs(18.001±8.179)μg/L]、维生素E[(5.678±2.436Objective To analyze the fat-soluble vitamin(FSV)levels of infants with cholestatic hepatopathy.Methods A total of 42 cases with infantile cholestatic hepatopathy(ICH)in Sheyang County People’s Hospital from January 2017 to February 2019 were selected as case group and 44 infants born in our hospital at the same period were selected as the control group.Infants in case group were divided into case group 1(18 cases)and case group 2(24 cases)according to whether pregnant women in late pregnancy and infants supplemented FSV or not.Infants in control group were divided into control group 1(22 cases)and control group 2(22 cases)according to the above criteria.Infants in case group were divided into breast feeding group,artificial feeding group and mixed feeding group,14 cases in each group.AU5811 automatic biochemical analyzer was used to detect liver function indexes,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),direct bilirubin(DBil)and total bile acid(TBA).Blood coagulation fuction indexes including prothrombin time(PT)and activated partial thromboplastin time(APTT)were detected by turbidimetry.Hperformance liquid phase tandem mass spectrometry was used to detect serum FSV levels,including vitamin A,vitamin D_(3),vitamin E and vitamin K.Comparison of the above indexes between the two groups were performed using an independent sample t test or rank sum test.Spearman rank correlation was used to analyze the correlation of FSV with ALT,AST,TBil and DBil.Results The age of infants in case group and control group were(96.53±9.21)d and(93.84±8.67)d,respectively,the difference was not statistically significant(t=1.395,P=0.083).The levels of vitamin A[(244.521±124.213)μg/L vs(380.705±133.289)μg/L],vitamin D_(3)[(17.459±6.399)μg/L vs(31.962±7.348)μg/L],vitamin E[(6.020±2.302)μg/L vs(18.735±4.326)μg/L]and vitamin K[(10.945±3.447)μg/L vs(22.375±5.655)μg/L]of infants in case group were significantly lower than those in control group,the differences were statis

关 键 词：婴儿 胆汁淤积性肝病 脂溶性维生素 

分 类 号：R725.7[医药卫生—儿科]