不同喂养方式对早产儿骨密度的影响  

Inflences of different feeding patterns on bone mineral density of premature infants

作　　者：李琳霞[1] 赵琳[1] 李艳红[1] 寸丽苹[1] 张娴[1] 王松[1] 

机构地区：[1]昆明医科大学第二附属医院儿科,650101

出　　处：《中国新生儿科杂志》2015年第2期104-107,共4页Chinese Journal of Neonatology

摘　　要：目的了解昆明地区早产儿超声骨密度的基础数据,探究不同喂养方式对其的影响。方法选择本院儿科2012年5月至2013年11月收治的早产儿,生后1周内和校正年龄3个月时利用高频超声骨密度测定仪检测左侧胫骨中1/3段内侧面骨密度,测定身长、体重等发育指标;校正年龄3个月时同时查血磷、血钙、碱性磷酸酶等指标。分析不同喂养方式对早产儿骨密度的影响。结果校正年龄3个月时,混合喂养组早产儿(55例)平均骨密度高于人工喂养组和纯母乳喂养组[(2 768±231)m/s比(2 609±93)m/s、(2 507±90)m/s],人工喂养组高于纯母乳喂养组,差异有统计学意义(P<0.05)。混合喂养组身长、体重、血钙、血磷高于人工喂养组和纯母乳喂养组,碱性磷酸酶低于人工喂养组和纯母乳喂养组,人工喂养组身长、体重、血钙、血磷高于纯母乳喂养组,碱性磷酸酶低于纯母乳喂养组,差异均有统计学意义(P<0.05);无论何种喂养方式,添加维生素D的早产儿骨密度值较未添加维生素D的早产儿明显增高,差异有统计学意义(P<0.05)。结论不同喂养方式对早产儿骨密度存在影响,混合喂养并添加维生素D相对于其他喂养方式可能更能促进骨密度的增长,较低胎龄早产儿母乳喂养需使用母乳强化剂。Objective To study the level of bone mineral density（ BMD） of premature infants in Kun Ming,Yunnan Province and to determine the influences of different feeding patterns on BMD.Methods Preterm infants admitted to our hospital between March 2012 and November 2013 were recruited. BMD was measured at the baby＇s left lower leg using Aonuo ultrasound bone sonometer within the first week after birth and at 3-month of corrected age. Body length and body weight were also reviewed at both timepoints. At 3-month of corrected age,we measured serum calcium,serum inorganic phosphorus and alkaline phosphatase. Influences of different feeding patterns on BMD of the participants were analyzed. Results The mean BMD of mixed-fed infants（ 55 cases,2 768 ± 231 m / s） was higher than exclusively breast-fed infants（ 2 609 ± 93 m / s） and formula-fed infants（ 2 507 ± 90） m / s at3-month of corrected age. The mean BMD of exclusively formula-fed infants was significantly higher than breast-fed infants（ P〈0. 05） at the same timepoint. Body length,body weight,serum calcium and serum inorganic phosphorus of mixed-fed infants were higher than breast-fed and formula-fed ones,and alkaline phosphatase of mixed-fed infants was the lowest among these three groups. Further more,body length,body weight,serum calcium,and serum inorganic phosphorus of formula-fed infants were higher than breast-fed ones,and alkaline phosphatase of formula-fed infants was lower than breast-fed ones（ P〈0. 05）. BMD of premature infants with Vitamin D supplementation was significantly higher than those without the supplementation,regardless of feeding pattern（ P〈0. 05）. Conclusions Different feeding patterns has different impacts on BMD of premature infants. Mixed feeding with Vitamin D supplementation may promote bone growth of preterm infants,comparing with other feeding patterns.Human milk fortifier should be added in breast milk for preterm infants with lower gestational age.

关 键 词：骨密度 营养科学 维生素D 代谢性骨病 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]