关键词: 　肠外营养；　胆汁淤积症；　危险因素；　早产儿

Abstract: Objective　To explore the clinical risk factors and short-term outcome of parenteral nutrition associatedcholestasis (PNAC) in preterm low birth weight infants. Methods　The clinical data of 114 preterm infants with low birth weight who were admitted to neonatal intensive care units and had parenteral nutrition (PN) ≥14 days and birth weight < 2500 g were analyzed retrospectively. According to the level of direct bilirubin (DB) in preterm infants, it was divided into PNAC group (DB> 34 μmol/L, 27 cases) and non PNAC group (87 cases). Alanine aminotransferase > 50 U/L was used as the standard for combined liver injury. And the differences were compared between the two groups. Results　The incidence of PNAC was 23.6%, and it occurred (32.8±12.5) d after PN application, and recovered (52.2±29.5) d after PN cessation. In the PNAC group, liver injury occurred in 14 patients (51.8%), and the occurrence time was (42.0±14.7) d after PN application. The duration of liver injury was 70.5 d (56.0~77.7 d), and the duration of cholestasis was (90.2±42.1) d. The hospitalization time, antibiotic application time, mechanical ventilation time, PN duration and fasting time in PNAC group were longer than those in non PNAC group, the age of starting feeding was later than that in non PNAC group, the cumulative dose of amino acid and lipids was larger than that in non PNAC group, and the proportions of necrotizing enterocolitis (NEC) and septicemia were higher than those in non PNAC group, and the differences were statistically significant (P all < 0.05). Multivariate logistic regression analysis showed that fasting time, PN duration and NEC were independent risk factors for PNAC (all P< 0.05). Conclusions　PNAC is a common complication of premature low birth weight infants during PN. Long time fasting, long duration of PN and complicated NEC increased the risk of PNAC. After treatment, the prognosis of PNAC is good.

Key words: 　parenteral nutrition;　cholestasis;　risk factor;　preterm infant