미숙아에서 정맥영양과 관련된 담즙정체의 발생에 대한 고찰

Abstract

For evaluate the intrahepatic cholestasis associated with PN, this study was performed one hundred premature infants who were admitted to the nursery of the department of Pediatrics, Dong-san Hospital, Keimyung University during a period of 27 months from June 1993 to August 1995, received PN for more than 2 weeks. The diagnosis of intrahepatic cholestasis was made by serum bilirubin level(direct bilirubin≥2.0gm/㎗), and excluded sepsis, viral hepatitis, biliary atresia and hemolytic disease. The following results were obtained. 1) Intrahepatic cholestasis was developed in 18 cases(18% of these infants), and mean time on of PN to onset of cholestasis was 28 days. 2) According to birth weight, the incidence of intrahepatic cholestasis associated with PN was 26.1% in 1,000∼1,499 gm group and 11.8% in 1,500∼1,999 gm group. 3) The average birth weight was significantly greater(p＜0.05) in the intrahepatic cholestasis associated with PN group(1,380±210gm) than the control group(1,510±240gm). 4) There was no correlation between two groups, in the days of PN, gestational age, total protein intake, average daily protein intake, age at start of oral feeding and age at start of PN. 5) Frequency of intrahepatic cholestasis between taurine containing amino acid solution(TrophAmine) group and taurine non-containing amnio acid solution(Proamin) group was significantly lower(p＜0.05) in the TrophAmine group(5.4 %) than the Proamin group(25.4 %). Our results indicated that weight was inversely correlated with intrahepatic cholestasis associated with PN. Taurine containing amino acid solution may play a role in prevention of intrahepatic cholestasis associated with PN.