{"title":"预测VLBW婴儿肠外营养相关性胆汁淤积(TPN)因素的多变量分析。","authors":"Y Y Yip, A K Lim, J R, K L Tan","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>To identify the factors predictive of development of TPN-related cholestasis, we conducted a historical cohort analysis of 62 VLBW infants who received TPN of which 17 developed cholestasis (27.4%). In the cholestatic group, the mean duration of TPN administration was significantly longer (25.7 days vs 8 days, p less than 0.001), the maximum daily amino-acids and lipids in the TPN infusate was significantly higher (amino-acids 2.25 vs 1.25 gm/kg/day, p less than 0.001; lipids 2.0 gm/kg/day vs 1.25 gm/kg/day, p less than 0.01), the duration of fasting was significantly longer (20.7 days vs 6.3 days, p less than 0.001) and the incidence of necrotizing enterocolitis was significantly higher (58.8% vs 15.5%, p 0.02). Using a linear discriminant analysis model with development of cholestasis as the dependent variable, the duration of TPN (p 0.0000) and the maximum daily amino-acid in infusate (p 0.0000) were found to be independent variables predictive of development of cholestasis. This model may serve to identify VLBW infants who will develop cholestasis during TPN.</p>","PeriodicalId":76683,"journal":{"name":"The Journal of the Singapore Paediatric Society","volume":"32 3-4","pages":"144-8"},"PeriodicalIF":0.0000,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A multivariate analysis of factors predictive of parenteral nutrition-related cholestasis (TPN cholestasis) in VLBW infants.\",\"authors\":\"Y Y Yip, A K Lim, J R, K L Tan\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To identify the factors predictive of development of TPN-related cholestasis, we conducted a historical cohort analysis of 62 VLBW infants who received TPN of which 17 developed cholestasis (27.4%). In the cholestatic group, the mean duration of TPN administration was significantly longer (25.7 days vs 8 days, p less than 0.001), the maximum daily amino-acids and lipids in the TPN infusate was significantly higher (amino-acids 2.25 vs 1.25 gm/kg/day, p less than 0.001; lipids 2.0 gm/kg/day vs 1.25 gm/kg/day, p less than 0.01), the duration of fasting was significantly longer (20.7 days vs 6.3 days, p less than 0.001) and the incidence of necrotizing enterocolitis was significantly higher (58.8% vs 15.5%, p 0.02). Using a linear discriminant analysis model with development of cholestasis as the dependent variable, the duration of TPN (p 0.0000) and the maximum daily amino-acid in infusate (p 0.0000) were found to be independent variables predictive of development of cholestasis. This model may serve to identify VLBW infants who will develop cholestasis during TPN.</p>\",\"PeriodicalId\":76683,\"journal\":{\"name\":\"The Journal of the Singapore Paediatric Society\",\"volume\":\"32 3-4\",\"pages\":\"144-8\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1990-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of the Singapore Paediatric Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of the Singapore Paediatric Society","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
为了确定预测TPN相关胆汁淤积发展的因素,我们对62名接受TPN的VLBW婴儿进行了历史队列分析,其中17名(27.4%)发生了胆汁淤积。在胆汁淤积组,TPN给药的平均持续时间明显更长(25.7天vs 8天,p < 0.001), TPN输注的最大每日氨基酸和脂质显著更高(氨基酸2.25 vs 1.25 gm/kg/天,p < 0.001;血脂2.0 gm/kg/day vs 1.25 gm/kg/day, p < 0.01),禁食时间显著延长(20.7天vs 6.3天,p < 0.001),坏死性小肠结肠炎发生率显著升高(58.8% vs 15.5%, p < 0.02)。采用以胆汁淤积发生为因变量的线性判别分析模型,发现TPN持续时间(p 0.0000)和每日最大氨基酸量(p 0.0000)是预测胆汁淤积发生的自变量。该模型可用于识别在TPN期间发生胆汁淤积的VLBW婴儿。
A multivariate analysis of factors predictive of parenteral nutrition-related cholestasis (TPN cholestasis) in VLBW infants.
To identify the factors predictive of development of TPN-related cholestasis, we conducted a historical cohort analysis of 62 VLBW infants who received TPN of which 17 developed cholestasis (27.4%). In the cholestatic group, the mean duration of TPN administration was significantly longer (25.7 days vs 8 days, p less than 0.001), the maximum daily amino-acids and lipids in the TPN infusate was significantly higher (amino-acids 2.25 vs 1.25 gm/kg/day, p less than 0.001; lipids 2.0 gm/kg/day vs 1.25 gm/kg/day, p less than 0.01), the duration of fasting was significantly longer (20.7 days vs 6.3 days, p less than 0.001) and the incidence of necrotizing enterocolitis was significantly higher (58.8% vs 15.5%, p 0.02). Using a linear discriminant analysis model with development of cholestasis as the dependent variable, the duration of TPN (p 0.0000) and the maximum daily amino-acid in infusate (p 0.0000) were found to be independent variables predictive of development of cholestasis. This model may serve to identify VLBW infants who will develop cholestasis during TPN.