天冬氨酸转氨酶与血小板比值指数对早产儿肠外营养相关性胆汁淤积症的预测价值

肝脏 ›› 2021, Vol. 26 ›› Issue (8): 917-919.

天冬氨酸转氨酶与血小板比值指数对早产儿肠外营养相关性胆汁淤积症的预测价值

蔡思铭, 岑红霞, 廖赵妹, 陈剑标

570311 海口海南医学院第二附属医院儿科二区

收稿日期:2020-09-13 出版日期:2021-08-31 发布日期:2021-09-29

Predictive value of aspartate aminotransferase to platelet ratio index in preterm infants with parenteral nutrition associated cholestasis

CAI Si-ming, CEN Hong-xia, LIAO Zhao-mei, CHEN Jian-biao

No.2 pediatric District, Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan, China

Received:2020-09-13 Online:2021-08-31 Published:2021-09-29

摘要/Abstract

摘要： 目的探讨天冬氨酸转氨酶与血小板比值指数(APRI)对早产儿肠外营养相关性胆汁淤积症(PNAC)的临床预测价值。方法回顾性分析海南医学院第二附属医院2018年3月至 2020年2月实施肠外营养治疗的极低体重早产儿132例,分为PNAC组和非PNAC组。记录肠外营养治疗后第1、2、3周直接胆红素(DB)、天冬氨酸氨基转移酶(AST)和血小板(PLT),计算APRI值。结果肠外营养治疗后第一周PNAC组APRI显著高于非PNAC组(P<0.05),DB、AST和PLT在两组之间无显著性差异(P>0.05);肠外营养治疗后第二周PNAC组APRI和DB显著高于非PNAC组(P<0.01),PLT显著低于非PNAC组(P<0.05),AST在两组之间无显著性差异(P>0.05);肠外营养治疗后第三周PNAC组APRI、DB和AST显著高于非PNAC组(P<0.05和P<0.01),PLT显著低于非PNAC组(P<0.01)。APRI曲线下面积为0.701,截断值取0.43,诊断效率最高,敏感度为78.6%,特异度为73.1%。结论 PNAC早产儿APRI会显著升高,早期监控APRI有利于PNAC早期发现。

关键词: 天冬氨酸氨基转移酶与血小板比值指数(APRI), 肠外营养相关性胆汁淤积症(PNAC), 早产儿

Abstract: Objective To explore the predictive value of aspartate aminotransferase to platelet ratio index(APRI) in preterm infants with parenteral nutrition associated cholestasis(PNAC).Methods A total of 132 extremely low birth weight preterm infants who received parenteral nutrition from March 2018 to February 2020 in our hospital were retrospectively analyzed. They were divided into PNAC group and non PNAC group. The levels of direct bilirubin (DB), aspartate aminotransferase (AST) and platelet (PLT) were recorded at 1, 2 and 3 weeks after parenteral nutrition treatment, and the APRI value was calculated.Results At the first week after parenteral nutrition treatment, APRI in PNAC group was significantly higher than that in non PNAC group (P<0.05), but DB, AST and PLT had no significant difference between the two groups (P>0.05). At the second week after parenteral nutrition treatment, APRI and DB in PNAC group were significantly higher than those in non PNAC group (P<0.01), and PLT was significantly lower than that in non PNAC group (P<0.05). AST had no significant difference between the two groups (P>0.05). At the third week after parenteral nutrition treatment, APRI, DB and AST in PNAC group were significantly higher than those in non PNAC group (P<0.05 and P<0.01), and PLT was significantly lower than that in non PNAC group (P<0.01). The AUC of APRI was 0.701, the cut-off value was 0.43, the sensitivity was 78.6%, and the specificity was 73.1%.Conclusion Early monitoring of APRI is beneficial to the early detection of PNAC.

Key words: Aspartate aminotransferase to platelet ratio index(APRI), Parenteral nutrition associated cholestasis(PNAC), Preterm infant

蔡思铭, 岑红霞, 廖赵妹, 陈剑标. 天冬氨酸转氨酶与血小板比值指数对早产儿肠外营养相关性胆汁淤积症的预测价值[J]. 肝脏, 2021, 26(8): 917-919.

CAI Si-ming, CEN Hong-xia, LIAO Zhao-mei, CHEN Jian-biao. Predictive value of aspartate aminotransferase to platelet ratio index in preterm infants with parenteral nutrition associated cholestasis[J]. Chinese Hepatolgy, 2021, 26(8): 917-919.

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