早产儿早期骨代谢生化指标变化及其与早期营养相关性  

Correlation analysis between early changes in biochemical markers of bone metabolism and early nutrition of preterm infants

作　　者：彭华保[1] 夏稳 谭若锟[1] 唐礼维 谭宁[1] 

机构地区：[1]南华大学附属郴州市第一人民医院新生儿科,423000

出　　处：《中国新生儿科杂志》2015年第3期188-191,共4页Chinese Journal of Neonatology

基　　金：郴州市第一人民医院科研项目(N2013-011)

摘　　要：目的探讨早产儿早期骨代谢生化指标状态变化,以及营养对其影响。方法选择2012年11月至2014年4月本院收治的胎龄30~35周早产儿,分别于生后24 h内及生后2周清晨8~9时采集静脉血,采用电化学发光法测定血清β-I型胶原羧基末端端肽（β-CTx）、骨钙素（OC）、Ⅰ型前胶原氨基端延长肽（PINP）水平,分析上述指标的动态变化及其与早期营养相关指标的关系。结果共纳入60例早产儿。生后24 h内血清β-CTx、OC、PINP水平之间无相关性（P〉0.05）;生后24 h内血清β-CTx与胎龄成负相关（r=-0.603,P〈0.05）,OC与胎龄成正相关（r=0.581,P〈0.05）,PINP水平与胎龄无相关（r=0.134,P〉0.05）。生后2周血清β-CTX、OC、PINP水平均较生后24 h内显著升高,差异有统计学意义（P〈0.05）;生后2周与生后24 h内的差值Δβ-CTx与ΔOC成正相关（r=0.600,P〈0.05）,Δβ-CTx与ΔPINP无相关（r=0.045,P〉0.05）,ΔOC与ΔPINP无相关（r=0.110,P〉0.05）。生后2周ΔOC与日均热卡、日均蛋白热卡比成正相关,与热卡累计缺失量成负相关（P〈0.05）,与日均奶量热卡、日均蛋白量、蛋白累计缺失量无相关（P〉0.05）;Δβ-CTx、ΔPINP与相关营养指标均无相关性（P〉0.05）。结论早产儿生后24 h内血清OC与胎龄成正相关,β-CTx与胎龄成负相关;生后2周骨代谢处于活跃状态,血清β-CTx、OC、PINP水平显著升高。早期提供合理热卡和适宜的蛋白热卡比对骨的正常发育具有重要意义。Objective To explore the changes of bone metabolic markers during early stage of preterm infants, as well as the relationship with their nutrition status. Methods Preterm infants with gestational age 30 -35 weeks admitted to our Hospital were collected from November 2012 to April 2013. Venous blood samples obtained within 24 hours after birth and between 8：00 -9：00 AM two weeks after birth were used to determine the Serum β-CTx, osteoealcin （OC） and propeptide of type I procollagen （PINP） levels by Electro-Chemiluminescence. Analysis of changes of these bone metabolic markers and their relationship with early stage nutrition related indicators were also performed. Results A total of 60 premature infants were collected. There was no significant correlation among serum β-CTx, OC and PINP within 24 hours after birth （ r = 0. 170, P 〉 0. 05 ）. The Serum β-CTx within 24 hours after birth was negatively correlated with gestational age （ r = -0. 603, P 〈 0. 05 ）, whereas the serum OC within 24 hours after birth was positively correlated with gestational age （r = 0. 581, P 〈 0. 05）. However, PINP wasn＇t correlated with gestational age significantly （r =0. 134,P 〉0. 05）. Serum 15-CTx, OC and PINP at 2 weeks after birth increased significantly from the baseline level detected within 24 hours after birth （ P 〈 0. 05 ）. △β-CTx was positively correlated with AOC （ r = 0. 600, P 〈 0. 05 ）. There was no significant correlation between APINP and △β-CTx （r = 0. 045,P 〉 0. 05 ）, as well as AOC and APINP （ r = 0. 110, P 〉 0. 05 ）. AOC was positively correlated with average daily calorie （P 〈 0. 05 ） and average daily P/E （ P 〈 0. 05 ）, negatively correlated with cumulative loss of caloric （P 〈 0. 05 ）. There was no significant correlation between △β-CTx or APINP with nutrition related indicators of this study. Conclusions Serum OC within 24 hours after birth of preterm infants and their gestational age are positively correlated, while △β-

关 键 词：婴儿 早产 营养科学 骨钙素 骨代谢指标 

分 类 号：R722.6[医药卫生—儿科]