早期应用不同剂量氨基酸与早产儿营养的关系  

Effect of early administration of amino acids with different doses on nutrition of preterm infants

作　　者：王金秀[1] 丁雪晶[1] 蒋曙红[1] 张进军[1] 张一鸣[1] 

机构地区：[1]南京医科大学附属常州市妇幼保健院,江苏常州213003

出　　处：《临床儿科杂志》2012年第11期1023-1026,共4页Journal of Clinical Pediatrics

基　　金：常州市卫生局局级基金项目(No.WZ201029)

摘　　要：目的评价早期使用不同剂量氨基酸对早产儿营养的作用。方法将接受静脉营养的83例早产儿(胎龄≤32周,出生体质量≤2 000 g)随机分成3组,大剂量组于生后24h内静脉给予氨基酸2.0g/(kg.d),每日递增1.0g/kg;中剂量组于生后24h内给予氨基酸1.0g/(kg.d)的,每日递增0.5g/kg;小剂量组生后24h内给予氨基酸0.5g/(kg.d),每日递增0.5g/kg;三组最大剂量为均3.5 g/(kg.d)。结果大剂量组恢复至出生体质量的时间较中剂量组和小剂量组明显缩短,差异有统计学意义(P<0.05);中剂量组与小剂量组比较差异无统计学意义。出生2周内体质量增长速度随氨基酸剂量增加而增快,各组间两两比较,差异均有统计学意义(P<0.05)。出生第7天的血清前白蛋白浓度,大剂量组较中剂量和小剂量组高,差异有统计学意义(P<0.05),中剂量组与小剂量组比较差异无统计学意义(P>0.05);出生第14天的血清前白蛋白浓度,各组间两两比较,差异均有统计学意义(P<0.05)。结论早期应用大剂量氨基酸可以改善早产儿的营养状况,促进生长发育。Objective To evaluate the effect of different doses of amino acids on the nutrition of preterm infant in early period after birth. Methods Eighty-three preterm infants （gestational age 432 weeks, birth weight 42 000 g） receiving total parenteral nutrition were randomly divided into three groups. In high-dose group, 2.0 g/（kg·d） of amino acids were given intra- venously within 24 hours after birth and the dose was increased progressively by increment of 1.0 g/（kg-d） per day. The dose of 1.0 g/（kg·d） and 0.5 g/（kg·d） of amino acids were given in medium-dose group and low-dose group, respectively, and increased progressively by increments of 0.5 g/（kg·d） per day. The maximum dose of 3 groups was 3.5 g/（kg·d）. Results It took less days to regain birth weight in high-dose group and significant difference was found between high-dose group and the other 2 groups （P〈O.01）. But the difference between medium-dose group and low-dose group was not significant. As the dose of amino acids increases, the rate of weight gain became faster in the frist 2 weeks after birth. The results of pair-wise comparison revealed the significant differences between different groups. Serum prealbumin concentration was significantly higher in high-dose group than that in the other 2 groups on clay 7 （P〈0.05） while there was no difference between medium and low-dose groups （P〉0.05）. On day 14, the serum prealbumin was significantly different in all 3 groups （P〈0.05）. Conclusions High-dose amino acid ad- ministration in premature infants in early days of life can improve premature infants＇ nutritional status, promote infant＇s growth and development.

关 键 词：氨基酸 前白蛋白 静脉营养 早产儿 

分 类 号：R722.6[医药卫生—儿科]