亲肠营养诱导的肝功能并发症:发生率,危险因素和预后
Jae Woo Park1, Sun Ah Maeng1, Sang Gyune Kim1
1Department of Internal Medicine, Gastroenterology and Hepatology, School of Medicine, Soonchunhyang University, Bucheon 14584, Republic of Korea.
Journal of clinical medicine
|February 26, 2025
概括
亲肠道营养相关的肝病 (PNALD) 即使在短期亲肠道营养 (PN) 中也可能发生. 识别肝病和感染等危险因素是预防PNALD的关键.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
背景情况:
- 亲肠道营养相关的肝病 (PNALD) 是亲肠道营养 (PN) 的严重并发症.
- 异常的肝功能测试 (LFTs) 和PNALD即使在短期PN接受者中也可能发生.
- 了解发病率和风险因素对于患者管理至关重要.
研究的目的:
- 调查接受PN的患者中PNALD和异常LFT的发生率,危险因素和结果.
- 为了确定异常LFT和PNALD的独立风险因素.
- 评估PN修改或停止对PNALD结果的影响.
主要方法:
- 500名接受PN至少3天的患者的回顾性分析.
- 在28天内监测肝酶水平.
- 分析PN持续时间,并发症,代谢因素和患者病史,以确定风险因素.
主要成果:
- 异常LFT的发生率为24.4%,PNALD为8.2%.
- 异常LFT的危险因素包括肝病,感染,PN持续时间和PN热量.
- 显著的PNALD风险因素包括肝病,肺病,最近的手术,PN持续时间,总胆固醇和HDL胆固醇.
- 85.3%的PNALD病例在PN修改或停止后得到改善.
结论:
- 异常的LFT和PNALD风险与短期PN使用有关.
- 必须确定患者特有的风险因素,以预测和预防PNALD.
- 修改或停止PN是有效的管理PNALD.
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