不同剂量氨基酸在早期静脉营养中对早产儿血生化指标及耐受性的影响  

Effects of different doses of amino acids on blood biochemical indexes and tolerance in premature infants during early parenteral nutrition

作　　者：姜开军[1] 席康明[1] 王强生[1] 尹远远[1] JIANG Kai-Jun;XI Kang-Ming;WANG Qiang-Sheng;et al.(Department of Neonatology , the First People＇s Hospital of Bengbu , Bengbu , Anhui 233000, Chin)

机构地区：[1]蚌埠市第一人民医院新生儿科,安徽蚌埠233000

出　　处：《中国妇幼保健》2018年第13期2975-2978,共4页Maternal and Child Health Care of China

基　　金：2014年安徽省卫生计生委科研计划项目(14FR001)

摘　　要：目的研究不同剂量氨基酸在早期静脉营养中对早产儿血生化指标及耐受性的影响,为临床治疗低体质量早产儿提供数据支持。方法选取2016年6月-2017年6月在该院出生的180例低体质量早产儿作为研究对象。根据随机数字法将早产儿分成高、中、低剂量组,每组60例。各组均常规给予脂肪乳、葡萄糖以及早产儿配方奶等营养物质,另外,每组患儿每日给予不同剂量的氨基酸静脉滴注,高剂量组首日剂量为3.0 g·kg^(-1),每日最高剂量<4.0 g·kg^(-1);中剂量组首日剂量为2.0 g·kg^(-1),每日最高剂量<3.7 g·kg^(-1);低剂量组首日剂量为1.0 g·kg^(-1),每日最高剂量<3.5 g·kg^(-1)。治疗7 d后对比各组疗效相关指标、血生化指标以及各组耐受性。结果高、中剂量组的最大体质量降低值、恢复至正常出生体质量的时间、肠外营养时间以及住院时间均分别明显低于低剂量组,且高剂量组明显低于中剂量组,差异均有统计学意义(均P<0.05)。高、中剂量组的头围增长明显高于低剂量组,且高剂量组又明显高于中剂量组,差异均有统计学意义(均P<0.05)。各组总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平、入院当日的前白蛋白(PA)、入院当日和治疗7 d后的谷草转氨酶(AST)、谷丙转氨酶(ALT)、p H、血肌酐(Cr)水平相比,差异均无统计学意义(均P>0.05)。高、中、低剂量组治疗7 d后PA水平均分别明显高于入院当日,且高、中剂量组明显高于低剂量组,而高剂量组又明显高于中剂量组,差异均有统计学意义(均P<0.05)。高剂量组耐受率均分别明显高于中剂量组和低剂量组,差异均有统计学意义(均P<0.05)。结论大剂量的氨基酸在对低体质量早产儿实施早期静脉营养的过程中疗效明显,且患儿可耐受,临床可考虑对此用药方案进行推广,从而更好地改善早产儿的生存预后。Objective To research the effects of different doses of amino acids on blood biochemical indexes and tolerance in premature infants during early parenteral nutrition, provide data support for clinical treatment of low weight premature infants. Methods From June 2016 to June 2017, 180 low weight premature infants born in the First People＇s Hospital of Bengbu were selected and divided into high dose group, middle dose group, and low dose group according to random number table, 60 premature infants in each group. The premature infants in the three groups were treated with conventional nutrition, including fat milk, glucose, and formula milk. The premature infants in the three groups were treated with different doses of amino acids every day. The dose of amino acids on the first day and the highest dose every day in high dose group were 3.0 g·kg^-1 and 〈4. 0 g·kg^-1, respectively. The dose of amino acids on the first day and the highest dose every day in middle dose group were 2. 0 g·kg^-1 and 〈3.7 g·kg^-1, respectively. The dose of amino acids on the first day and the highest dose every day in low dose group were 1.0g·kg^-1 and 〈3.5 g·kg^-1, respectively. At 7 days after treatment. The related indexes of curative effect, blood biochemical indexes, and tolerance in the three groups were compared. Results The reduction of maximal weight, the time of return to normal birth weight, parenteral nutrition time, and hospitalization time in high dose group and middle dose group were statistically significantly lower than those in low dose group （P〈0. 05 ） . The reduction of maximal weight, the time of return to normal birth weight, parenteral nutrition time, and hospitalization time in high dose group were statistically significantly lower than those in middle dose group （P〈0. 05）. The increasing values of head circumference in high dose group and middle dose group were statistically significantly higher than those in low dose group （P〈0. 05 ） . The increasing value of head circumference in hi

关 键 词：不同剂量 氨基酸 早期静脉营养 早产儿 血生化指标 耐受性 

分 类 号：R722.6[医药卫生—儿科]