A study on the subclinical hepatic dysfunction as a causative factor of infantile vitamin K deficiency hemorrhage

亚临床肝功能障碍导致婴儿维生素K缺乏性出血的研究

基本信息

批准号：
60480246
负责人：
SHIRAKI Kazuo
金额：
$ 3.01万
依托单位：
Tottori University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1985
资助国家：
日本
起止时间：
1985 至 1987
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-60480246/
关键词：
Infantile vitamin K deficiency hemmorrhage cholestasis bile acid PIVKA-II ビタミンK 肝機能障害

项目摘要

Infantile vitamin K deficiency hemmorrhage is a serious disease, mainly seen in breast-fed infants during early infancy, usually without any apparent causes. We suspected the liver function somehow related to the development of this desease, and studied to elucidate its role as a causative factor of this disease.1. Eight out of nine infants, who showed low normotest at the age of three weeks, developed hepatic dysfunction later.2. Serum levels of rapid turnover proteins, such as ceruloplasmin, were elevated in the patients, as well as in the infants who showed low normotest. These results suggested that there was no impairment in the production of the proteins, but there existed bile stasis in the infants with vitamin K deficiency.3. Serum bile acids were determined in eight infants with vitamin K deficiency with gas-chromatography. All the infants showed markedly elevated serum total bile acid and high C/CDC ratio, which strongly suggested the existense of bile stasis.4. Vitamin K was administered p.o. to 194 normal newborn infants at the age of 5 days, and serum level of vitamin K and serum PIVKA-II were determined. Among them, seven infants showed no elevation of serum vitamin K after 3 hours post vitamin K adminstration, of whom six became positive for PIVKA- II at the age of 3 weeks, suggesting the presence of vitamin K deficiency.The results of the present study clearly indicate that malabsorption of vitamin K due to "physiologic" cholestasis in early infancy plays an important role in the development of idiopathic infantile vitamin K deficiency hemorrhage.

婴儿维生素K缺乏性出血是一种严重的疾病，主要见于婴儿早期母乳喂养的婴儿，通常没有任何明显原因。我们怀疑肝功能与这种疾病的发生有某种关系，并研究阐明其作为这种疾病的致病因素的作用。 1．九名婴儿中的八名在三周时表现出低正常测试，随后出现肝功能障碍。2．患者以及正常测试结果较低的婴儿的快速周转蛋白（例如铜蓝蛋白）的血清水平升高。这些结果表明，维生素K缺乏婴儿的蛋白质生成没有受到损害，但存在胆汁瘀滞。3．采用气相色谱法测定了 8 名维生素 K 缺乏症婴儿的血清胆汁酸。所有婴儿血清总胆汁酸均明显升高，C/CDC比值升高，强烈提示存在胆汁瘀滞。4．维生素 K 口服给药。选取194名5日龄正常新生儿，测定血清维生素K和血清PIVKA-II水平。其中，7名婴儿在服用维生素K后3小时后血清维生素K没有升高，其中6名婴儿在3周龄时PIVKA-II呈阳性，表明存在维生素K缺乏。本研究结果清楚地表明，婴儿早期“生理性”胆汁淤积导致的维生素 K 吸收不良在特发性婴儿维生素 K 缺乏性出血的发生中起着重要作用。