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The diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants

Korean Journal of Pediatrics 2006;49(8):851-856.
Published online August 15, 2006.
The diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants
Kyoung Soo Park, Myung Seok Shin, Mea Young Chang
Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea
총정맥영양에 의한 미숙아 담즙정체증에서 혈청 담즙산의 진단적 의의
박경수, 신명석, 장미영
충남대학교 의과대학 소아과학교실
Correspondence: 
Mea Young Chang, Email: mychang@cnuh.co.kr
Abstract
Purpose
: The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants.
Methods
: Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, γ-glutamic acid transferase, and alkaline phosphatase of premature infants with total parenteral nutrition induced cholestasis were measured for comparison and analysis of their correlation.
Results
: Changes of serum bile acid analysis after birth showed no significant difference between boys and girls, between premature infants and term infants without cholestasis. Serum bile acid levels are constant after two weeks after birth in neonates without cholestasis. In premature infants with total parenteral nutrition induced cholestasis, the increase of serum direct bilirubin over 2 mg/ dL was 34.9±18.3 days after birth, and the increase of serum bile acid was 28.1±18.3 days. Its increase was about 1 week faster than serum direct bilirubin, however, there was no statistical significance(P=0.114). Comparing analysis of serum bile acid, γ-glutamic acid transferase, and alkaline phosphatase, serum bile acid showed the highest correlation to serum direct bilirubin(r=0.487, P= 0.000).
Conclusion
: Serum bile acid is an important parameter of total parenteral nutrition induced cholestasis in premature infants and will be useful for early diagnosis and treatment.
Key Words: Serum bile acid , Premature , Total parenteral nutrition , Cholestasis


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