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