早产儿生化代谢指标的相关性研究  

Correlation Study of Biochemical and Metabolic Indexes in Preterm Infants

作　　者：王鉴 陈晓霞[1] 杨萌婷 童雪涛[2] 黄康[1] 陈茂琼[1] 

机构地区：[1]贵州医科大学附院新生儿科,贵州贵阳550004 [2]贵州医科大学附院儿科,贵州贵阳550004

出　　处：《贵阳医学院学报》2015年第8期828-833,共6页Journal of Guiyang Medical College

基　　金：贵州省科技厅科学技术基金[黔科合J字(2009)2160号];贵州省科技厅社发攻关项目基金(黔科合字2010-3082号)

摘　　要：目的：探讨生化代谢指标与体格发育指标的相关性,分析影响生化代谢指标的相关因素。方法：早产儿共126例,根据胎龄和出生体质量的关系,将其分为小于胎龄儿（SGA）组及适于胎龄儿（AGA）组;于出生后1周内、6月、12月、24月、36月取清晨空腹外周静脉血3 m L,分别检测胰岛素（INS）、C肽、IGF-1、甘油三酯（TC）、总胆固醇（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、空腹血糖（FBG）、清蛋白、前清蛋白、肌酐等生化代谢指标,同时测量体重、身长、头围、胸围、腹围等体格指标;计算胰岛素抵抗指数（IRI）、Ponderal指数及Kaup指数、体质量标准差计分（SDS）、身长SDS,分析生化代谢指标与体格指标的相关性,同时对体质量和身长发育落后危险因素进行Logistic分析。结果：早产儿IGF-1在生后逐渐升高,12-24月达高峰;体重SDS与IGF-1、TC、白蛋白、前白蛋白正相关（P〈0.05,r=0.265、0.219、0.315、0.21）,与Lg IRI负相关（P〈0.05,r=-0.23）;身长SDS与IGF-1、清蛋白、前清蛋白正相关（P〈0.05,r=0.274、0.226、0.202）,与Lg IRI负相关（P〈0.05,r=-0.21）;Kaup指数与IGF-1、TG、清蛋白、前清蛋白正相关（P〈0.05,r=0.248、0.234、0.38、0.281）,与Lg IRI、C肽、肌酐负相关（P〈0.05,r=-0.19、-0.22、-0.49）;头围与IGF-1、TC、LDL、清蛋白、前清蛋白正相关（P〈0.05,r=0.481、0.43、0.272、0.615、0.706）,与C肽、肌酐负相关（P〈0.05,r=-0.20、-0.21）;胸围与IGF-1、TC、清蛋白、前清蛋白正相关（P〈0.05,r=0.505、0.3、0.608、0.704）,与Lg IRI、C肽、肌酐负相关（P〈0.05,r=-0.19、-0.22、-0.19）;腹围与IGF-1、TC、清蛋白、前清蛋白、肌酐正相关（P〈0.05,r=0.312、0.25、0.31、0.37、0.39）;体重发育落后影响因素为SGA（OR=5.668）;身长发育落后影响因素为出生体重〈1 500 g（OR=5.449）。结论：了解早产儿生化代谢指标与体格发育的相�Objective：To investigate correlation between biochemical and metabolic indexes and physical development indexes,analyzing the related factors influence on growth and biochemical and metabolic indexes. Methods：A total of 126 preterm infants were divided into small for gestational age （ SGA）infant group and appropriate for gestational age（ AGA）infant group according to gestational age and birth weight. 3 mL peripheral venous blood sample were taken in the early morning during fasting in the first week,6,12,24,36 months after birth. They were tested for levels of INS,C pep-tide,IGF-1,TC,TG,HDL-C,LDL-C,FBG,albumin,prealbumin and creatinine respectively. At the same time,physical indexes,including weight,body length,head circumference,chest circumfer-ence,abdominal circumference,insulin resistance index（ IRI）,ponderal index,weight standard devi-ation score（ SDS）and body length SDS were measured. Analyzing the correlation between biochemical and metabolic with physical index,and carrying Logistic analysis on body mass and developmental de-lay factors. Results：IGF-1 increased after birth gradually and reached the highest level by 12 ~24 month after birth. Weight SDS was positively correlated with IGF-1,TC,albumin,prealbumin（ P﹤0. 05 ,r=0 . 265 ,0 . 219 ,0 . 315 ,0 . 21 ）,negative correlation with LgIRI（ P﹤0 . 05 ,r= -0 . 23 ）;Height SDS was positively correlated with IGF-1,albumin,prealbumin（P﹤0. 05,r=0. 274,0. 226, 0 . 202 ）,negative correlation with LgIRI（ P﹤0 . 05 ,r= -0 . 21 ）;Kaup index was positively correla-ted with IGF-1,TG,albumin,prealbumin（P﹤0. 05,r=0. 248,0. 234,0. 38,0. 281）,negative cor-relation with LgIRI,C peptide,creatinine（P﹤0. 05,r= -0. 19,-0. 22,-0. 49）;head circumfer-ence was positively correlated with IGF-1,TC,LDL-C,albumin,prealbumin（ P﹤0. 05,r=0. 481, 0. 43,0. 272,0. 615,0. 706）,negative correlation with C peptide,creatinine（P﹤0. 05,r= -0. 20,-0. 21）;chest was positively correlated with IGF-1,TC,albumin,prealbumin（P﹤0. 05,r

关 键 词：婴儿 早产 胰岛素样生长因子-1 代谢 儿童发育 回归分析 

分 类 号：R722.6[医药卫生—儿科]