不同胎龄早产儿生后早期对脂肪乳的耐受性研究  

Fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth

作　　者：唐慧[1] 杨传忠[1] 李欢[1] 文伟 黄芳芳 黄智峰[1] 石玉萍[1] 余彦亮[1] 陈丽莲[1] 袁瑞琴[1] 朱小瑜[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院新生儿科,广东深圳518028 [2]南方医科大学附属深圳市妇幼保健院新生儿筛查中心,广东深圳518028

出　　处：《中国当代儿科杂志》2017年第6期632-637,共6页Chinese Journal of Contemporary Pediatrics

基　　金：深圳市科技计划项目(201201025)

摘　　要：目的分析不同出生胎龄早产儿生后早期对脂肪乳的耐受性。方法 98例早产儿分为超早产儿组(n=17)、早期早产儿组(n=48)和中晚期早产儿组(n=33),再根据脂肪乳剂量分为低剂量脂肪乳与高剂量两个亚组,留取脐血及生后前3 d的血干滤纸片,用串联质谱法检测短、中、长链酰基肉碱含量。结果超早产儿组与早期早产儿组脐血及生后前3 d长链酰基肉碱浓度均低于中晚期早产儿组(P<0.05),且长链酰基肉碱浓度与胎龄呈正相关(P<0.01)。超早产儿低剂量脂肪乳组生后第2天的短、中、长链酰基肉碱浓度均高于高剂量组(P<0.05),而早期早产儿与中晚期早产儿不同剂量脂肪乳亚组的生后3 d短、中、长链酰基肉碱浓度差异均无统计学意义。结论超早产儿和早期早产儿生后前3 d对长链脂肪酸的代谢能力均低于中晚期早产儿;早期早产儿与中晚期早产儿生后早期可以耐受高剂量脂肪乳,但超早产儿生后早期对高剂量脂肪乳代谢能力可能不足。Objective To investigate the fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth. Methods A total of 98 preterm infants were enrolled and divided into extremely preterm infant group （n=lT）, early preterm infant group （n=48）, and moderate-to-late preterm infant group （n=33）. According to the dose of fat emulsion, they were further divided into low- and high-dose subgroups. The umbilical cord blood and dried blood filter papers within 3 days after birth were collected. Tandem mass spectrometry was used to measure the content of short-, medium-, and long-chain acylcarnitines. Results The extremely preterm infant and early preterm infant groups had a significantly lower content of long-chain acylcarnitines in the umbilical cord blood and dried blood filter papers within 3 days after birth than the moderate-to-late preterm infant group （P〈0.05）, and the content was positively correlated with gestational age （P〈0.01）. On the second day after birth, the low-dose fat emulsion subgroup had a significantly higher content of short-, medium-, and long-chain acylcamitines than the high-dose fat emulsion subgroup among the extremely preterm infants （P〈0.05）. In the early preterm infant and moderate-to-late preterm infant groups, there were no significant differences in the content of short-, medium-, and long-chain acylcarnitines between the low- and high-dose fat emulsion subgroups within 3 days after birth. Conclusions Compared with moderate-to- late preterm infants, extremely preterm infants and early preterm infants have a lower capacity to metabolize long-chain fatty acids within 3 days after birth. Early preterm infants and moderate-to-late preterm infants may tolerate high-dose fat emulsion in the early stage after birth, but extremely preterm infants may have an insufficient capacity to metabolize high-dose fat emulsion.

关 键 词：脂肪乳 代谢组学 酰基肉碱 串联质谱 早产儿 

分 类 号：R722.6[医药卫生—儿科]