抄録
Liver function derangement is one of the most common complications of total parenteral nutrition (TPN) in pediatric patients, especially in neonates. Recent studies suggest the positive relationship between intestinal overgrowth of anaerobic bacteria and liver dysfunction during TPN. Therefore, we investigated the effect of Metronidazole (MNZ) on hepatic dysfunction associated with TPN in neonates. Neonatal patients on TPN for more than 2 weeks were devided into 3 groups. In Group I TPN alone was given, in Group II MNZ 25 mg/kg/day was administered intravenously for the first 2 weeks of TPN, and in Group III 50 mg/kg/ day of MNZ was given for 3 weeks. The maximal levels of liver function tests during the first one month of life were compared among these 3 groups. There was no significant difference between Group I and Group II. Although as to ALP, γGTP, direct bilirubin and total bile acid there was no significant difference between Group I and Group III, transaminase (GOT and GPT) of Group III remained significantly low compared with that of Group I (p<0.05). MNZ prevented, at least, the elevation of transaminase during TPN in neonates, suggesting that the possible involvement of anaerobic bacterial flora of the intestine in the pathogenesis of TPN-associated liver function derangement.
