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目的探讨血清脂联素(APN)在极低出生体重早产儿静脉营养性胆汁淤积(PNAC)风险评估中的作用。方法选取2015年1月-2016年12月该院NICU收治的112例极低体重早产儿为研究对象,将血清APN≥13.15 mg/L的51例患儿设为高APN组,血清APN<13.15 mg/L的61例患儿为低APN组。记录5周内患儿PNAC情况,分析PNAC发病率及其与APN水平的相关性。结果低APN组PNAC的发生率在第2~5周呈现上升趋势,但血清APN水平则呈现逐步下降趋势。高APN组PNAC的发生率在第2~5周也呈现上升趋势,但血清APN水平变化不明显。两组PNAC发生率差异有统计学意义(P<0.01)。单因素分析显示,APN水平是影响患者远期预后的独立危险因素(P<0.05)。结论早产儿血清APN参与PNAC的发生发展过程,血清APN可作为极低体重早产儿静脉营养性PNAC的评估预测指标,具有前瞻性,创伤小且检测便捷,对于极低体重早产儿静脉营养及危重抢救有重要价值。
Objective To investigate the role of serum adiponectin (APN) in the risk assessment of parenteral nutrition cholestasis (PNAC) in very low birth weight infants. Methods From January 2015 to December 2016,112 cases of very low birth weight preterm infants admitted to NICU in this hospital were enrolled. 51 children with serum APN≥13.15 mg / L were selected as high APN group and serum APN <13.15 Sixty-one children with mg / L had low APN. Record PNAC in children within 5 weeks, analyze the incidence of PNAC and the correlation with APN level. Results The incidence of PNAC in low APN group increased from the second week to the fifth week, but the serum APN level showed a gradual downward trend. The incidence of PNAC in high APN group also showed an upward trend in weeks 2 to 5, but the serum APN level did not change significantly. There was a significant difference in the incidence of PNAC between the two groups (P <0.01). Univariate analysis showed that APN level was an independent risk factor affecting long-term prognosis of patients (P <0.05). Conclusions Serum APN in preterm infants is involved in the development and progression of PNAC. Serum APN can be used as a predictor of PNAC in preterm infants with very low birth weight. It is prospective, less traumatic and more convenient for detection of parenteral nutrition and risk of preterm infants with very low birth weight Rescue has important value.