[1]李惠芳,白岳飞.新生儿败血症相关性胆汁淤积症临床表现及危险因素分析[J].陕西医学杂志,2021,50(3):338-341.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.021]
　LI Huifang,BAI Yuefei.Clinical manifestations and risk factors of neonatal sepsis-related cholestasis[J].,2021,50(3):338-341.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.021]
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新生儿败血症相关性胆汁淤积症临床表现及危险因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年3期
页码:
338-341
栏目:
临床研究
出版日期:
2021-03-01

文章信息/Info

Title:
Clinical manifestations and risk factors of neonatal sepsis-related cholestasis
作者:
李惠芳1; 白岳飞2
(1.铜川市妇幼保健院儿科,陕西 铜川 727000; 2.西北大学附属神木医院新生儿科,陕西 神木 719300)
Author(s):
LI Huifang; BAI Yuefei
(Department of Pediatrics,Tongchuan City Maternal and Child Health Care,Tongchuan 727000,China)
关键词:
新生儿;  败血症;  胆汁淤积症;  危险因素;  细菌感染;  胆红素
Keywords:
Neonate;  Sepsis;  Cholestasis;  Risk factors;  Bacterial infection;  Bilirubin
分类号:
R 722.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.03.021
文献标志码:
A
摘要:
目的:观察新生儿败血症相关性胆汁淤积症的临床表现,分析其危险因素。方法:选取100例败血症新生儿为研究对象,其中合并相关性胆汁淤积症患儿38例(观察组),未合并相关性胆汁淤积症患儿62例(对照组)。观察两组患儿血液细菌培养情况,对比两组患儿肝功能障碍及病死情况,并分析新生儿败血症相关性胆汁淤积症的相关危险因素。结果:观察组38例患儿中血液细菌培养呈阳性者21例,对照组62例患儿中血液细菌培养呈阳性者26例。观察组患儿肝功能障碍及病死情况均高于对照组(均P<0.05)。两组患儿住院天数、肠外营养、总胆红素、直接胆红素、胆汁排秘系统发育、革兰阴性菌感染、血清内毒素水平比较均有统计学差异(均P<0.05)。Logistic回归分析结果显示,住院天数≥63.04 d、有肠外营养、总胆红素≥2.07 mg/dl、直接胆红素≥14.76 mg/dl、胆汁排秘系统发育不完善和血清内毒素≥16.31 pg/ml为败血症相关性胆汁淤积症的独立危险因素(均P<0.05)。结论:新生儿败血症相关性胆汁淤积症多与细菌感染有关,后者导致血清内毒素水平升高是合并胆汁淤积症的主要原因。胆汁排秘系统发育不完善、进行肠外营养和住院时间长也会增加新生儿败血症相关性胆汁淤积症的风险。败血症相关性胆汁淤积症新生儿会出现总胆红素、直接胆红素升高现象,导致肝功能障碍发生率与病死率增加。
Abstract:
Objective:To observe the clinical manifestations of neonatal sepsis-related cholestasis and analyze its risk factors.Methods:100 neonates with sepsis were selected as the research objects,including 38 children with associated cholestasis(observation group)and 62 children without associated cholestasis(control group).The blood bacterial culture of the two groups was observed,and the liver dysfunction and death of the two groups were compared,and the related risk factors of neonatal sepsis-related cholestasis were analyzed.Results:Among the 38 children in the observation group,21 cases had positive blood bacterial culture,and 26 cases of the 62 children in the control group had positive blood bacterial culture.The liver dysfunction and death in the observation group were higher than those in the control group(all P<0.05).There were statistical differences in hospitalization days,parenteral nutrition,biliary excretion system development,gram-negative bacterial infection,and total bilirubin,direct bilirubin,serum endotoxin levels between the two groups(all P<0.05).Logistic regression analysis showed that hospitalization days was not less than 63.04 days,total bilirubin was not less than 2.07 mg/dl,direct bilirubin was not less than 14.76 mg/dl,serum endotoxin was not less than 16.31 pg/ml,parenteral nutrition and imperfect development of the biliary excretion system were independent risk factors for sepsis-related cholestasis(all P<0.05).Conclusion:Neonatal sepsis-associated cholestasis is mostly related to bacterial infection,and the latter leads to increased serum endotoxin levels,which is the main cause of associated cholestasis.Incomplete development of the biliary secretion system,parenteral nutrition,and long hospital stays also increase the risk of neonatal sepsis-related cholestasis.In neonates with sepsis-related cholestasis,total bilirubin and direct bilirubin will increase,leading to an increase in the incidence of liver dysfunction and mortality.

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更新日期/Last Update: 2021-03-04