宫外生长迟缓早产儿氮平衡变化  

Changes of the nitrogen balance in premature infants with extrauterine growth restriction

作　　者：徐文英[1] 吕艳关[2] 岳虹霓[1] 张丽[1] 王玉美[1] 武荣[2] 

机构地区：[1]扬州大学医学院附属淮安市妇幼保健院儿保科,江苏省淮安市223002 [2]扬州大学医学院附属淮安市妇幼保健院新生儿医学中心,江苏省淮安市223002

出　　处：《中华临床营养杂志》2015年第6期362-367,共6页Chinese Journal of Clinical Nutrition

基　　金：基金项目：江苏省妇幼健康科研重点资助项目（F201507）

摘　　要：目的观察住院期间宫外生长迟缓（EUGR）早产儿氮平衡的变化规律。方法选择2014年5至10月入住扬州大学医学院附属淮安市妇幼保健院新生儿医学中心的出生胎龄〈32周且出生后24h内入院的小早产儿（VP）64例，根据是否符合EUGR诊断标准分为EUGR组（18例）和非EUGR组（46例）。采用凯氏测氮法分别测定所有VP出生后第1、7、14、28天尿液中的尿素氮水平。分别计算和比较两组早产儿在各个时间点的氮平衡值。结果两组VP出生后第1、7、14、28天的氮平衡值均呈负值，且氮平衡值随着日龄的增加呈上升趋势。EUGR组出生后第1、7、14、28天尿液中的氮平衡值（-492．66±204．39、-290．79±173．78、-205．96±180．59、-145．14±140．15）比较，差异有统计学意义（F=53．086，P=0．000）。非EUGR组出生后第1、7、14、28天尿液中的氮平衡值（-383．41±130．57、-278．91±225．80、-182．00±144．70、-61．08±49．71）比较，差异有统计学意义（F=41．745，P=0．000）。EUGR组VP出生后各个时间点的氮平衡值均低于非EUGR组，其中出生后第1、28天的氮平衡值比较，差异有统计学意义（均P〈0．05）；其他时间点比较，差异均无统计学意义（均P〉0．05）。结论VP住院期间均呈负氮平衡状态，其中EUGR早产儿更为严重。Objective To observe changes of the nitrogen balance in premature infants with extrauterine growth restriction （EUGR） during hospitalization. Methods We selected a total of 64 very preterm （VP） in- fants admitted to Neonatal Medical Center of Huai＇an Maternity and Child Heahhcare Hospital affiliated to School of Medicine, Yangzhou University within 24 hours after birth and with gestational age 〈 32 weeks from May to October 2014, and divided them into EUGR group （n = 18） and non-EUGR group （n =46） according to the diagnostic criteria of EUGR. All of the infants＇ urea nitrogen levels were detected by Kjeldahl method on the 1st, 7th, 14th, and 28th days after birth, and nitrogen balance scores were calculated and compared be- tween the EUGR and non-EUGR groups. Results Nitrogen balance scores of the two groups were all negative on the 1st, 7th, 14th, and 28th days after birth, with a tendency rising with days. A significant difference was showed in the intra-group comparison in EUGR group on the 1st, 7th, 14th, and 28th days after birth （ -492. 66 ±204. 39, -290. 79 ± 173.78, -205.96 ± 180. 59, and - 145.14 ± 140. 15, respectively, F =53. 086, P =0. 000） , so was in the non-EUGR group （ -383.4l ± 130. 57, -278.91 ±225.80, - 182. 00 ± 144.70, and - 61.08 ±49.71, respectively, F = 41. 745, P = 0.000）. At each observation time point after death, the nitrogen balance score in the EUGR group was lower than in the non-EUGR group, and the differ- ences on the 1st and 28th days were statistically significant （ both P 〈 0. 05 ） ; while those on the other time points were not statistically significant （ both P 〉 0. 05）. Conclusion The VP infants are at a negative nitro- gen balance during hospitalization, among whom the EUGR premature infants may be more serious.

关 键 词：宫外生长迟缓 早产儿 小早产儿 氮平衡 

分 类 号：R722.6[医药卫生—儿科]