ＴＰＮ施行患者の肝機能異常症例の検討

Abstract

It has been reported that TPN (Total Parenteral Nutrition) causes many adverse events, among them hepatic dysfunction. In the present study, we investigated the occurrence of hepatic dysfunction in patients receiving TPN through laboratory measurement of serum AST and ALT levels, in consideration of TPN composition and co-administered drugs.Twenty-eight patients were enrolled for this study, all of whom had received TPN and been discharged without complications. In the selection process, patients who were not operated on or had lung cancer were excluded. The average age was 68.2 9.8 years and average period of TPN was 18.2 ± 10.0 days. The subjects were divided into a normal and an abnormal group, the former being normal for both AST and ALT serum levels, and the later abnormal for both AST and ALT levels.In the abnormal group, there was a tendency for subjects to have received TPN for a longer period, for the NPC of the TPN to be higher and free amino acids to be lower as compared with the normal group, although these differences were not significant. The NPC/N ratio was in the normal range, although it was higher in the abnormal group than in the normal group. Though the percentage antibiotic and H2-blocker use was slightly higher in the abnormal group, this difference was not significant. In the absence of significant differences in such factors between the groups, we were unable to pinpoint the cause of the hepatic dysfunction so this issue will require further investigation.