| Objective To investigate the change levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(GGT)and total bile acid(TBA)in different periods of neonatal sepsis,so as to provide evidence for the early detection of liver damage.To understand the effects of early-onset sepsis and late-onset sepsis on liver function,and compare whether there are differences in the effects of different pathogens on liver function.Methods A retrospective study of 100 cases of NICU hospitalized in our hospital from January 2018 to October 2020 that met the diagnostic criteria of neonatal sepsis in the fifth edition of "Practical Neonatology" was conducted retrospectively and divided into 2 groups:early onset sepsis group(diagnosed sepsis within 3 days of birth)40 cases,late-onset sepsis group(born three days in the diagnosis of sepsis or higher)60 cases,collected the detection values of ALT,AST,GGT and TBA on day 1,3,7 and 14 of sepsis diagnosis;The control group was the ALT,AST,GGT and TBA values of non-infected children hospitalized in NICU.Results(1)The early-onset sepsis group and late-onset sepsis group were compared with the control group in terms of gender,gestational age and birth weight,P>0.05,the difference was not statistically significant and comparable.(2)The ALT,AST and TBA of the early-onset sepsis group were significantly higher than those of the control group,with statistical differences(P<0.05);there was no statistical difference between the GGT early-onset sepsis group and the control group(P>0.05).The ALT,AST,GGT and TBA of the late-onset sepsis group were significantly higher than those of the control group,with statistical differences(P<0.05).(3)ALT and TBA in the early-onset sepsis group increased significantly on the 3rd day,and showed an overall upward trend during the course of the disease,while AST and GGT showed an overall downward trend during the course of the disease.The 7th and 14th days of AST were compared with the 1st day,P<0.05,the difference was statistically significant.GGT and TBA on the 3rd,7th,and 14th days were compared with the 1st day P<0.05,the difference was statistically significant.(4)In the late-onset sepsis group,ALT increased significantly on the 3rd day,and showed an upward trend during the course of the disease;AST showed a downward trend;TBA increased significantly in the late stage,reaching the highest on the 14th day,and the difference on the seventh day was statistically significant compared with the first and third days(P<0.05).Comparing the 14th day with the 1,3 and 7 days,the P were all<0.05,the difference was statistically significant.(5)In the late-onset sepsis group,The ALT was higher in the gram-positive bacteria group than in the gram-negative Group(P<0.05);on the 7th day,the TBA in the fungal group was higher than that of the gram-negative bacteria group and gram-positive Bacteria group(P<0.05).TBA on the 14th day,the fungus group was higher than the Gram-negative bacteria group(P<0.05).Conclusion Neonatal sepsis can damage liver function and increase liver enzymes ALT,AST and GGT.At the same time,sepsis can also lead to increase of TBA.Therefore,routine monitoring of liver function indexes ALT,AST,GGT and TBA during the course of sepsis is helpful for early detection of liver damage.ALT increased significantly on the 3rd day in both the early and late sepsis groups,suggesting that it is clinically meaningful to start monitoring ALT on the 3rd day in the course of sepsis.TBA was significantly increased in the late stage of sepsis,so attention should be paid to the change of TBA level in the late stages of the disease,and the time of parenteral nutrition should be minimized.If necessary,cholagogic drugs can be used to treat cholestasis.In short,early treatment of sepsis and early identification of sepsis-related liver dysfunction are the key to improving the prognosis;When liver damage occurs,timely hepatoprotective treatment can help the recovery of the disease. |
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