大剂量口服补锌促进极低出生体重早产儿肠道喂养和生长的临床试验研究  

Oral zinc supplementation promoted enteral feeding and bodyweight growth in very-low-birthweight preterm neonate

作　　者：申新田 梁小琴[1] 黄宜娥 谢少洁 李惠玲[1] 杨艺[1] SHEN Xin Tian;LIANG Xiao Qin;HUANG Yi E;XIE Shao Jie;LI Hui Ling;Yang Yi(Bao ＇ an Maternal and Child Health Hospital, Shenzhen 518103, China)

机构地区：[1]深圳市宝安区妇幼保健院,518103

出　　处：《中国妇幼卫生杂志》2018年第4期10-14,共5页Chinese Journal of Women and Children Health

基　　金：深圳市宝安区科技创新局医疗卫生科研课题(2016CX254)

摘　　要：目的初步探索大剂量补充锌对促进早产儿肠道喂养和生长的机制。方法 2017年4-12月在深圳市宝安区妇幼保健院新生儿重症监护室开展随机、双盲、单中心、安慰剂对照前瞻性临床试验。生后第10天早产儿随机分入两组:补锌组(6 mg/天,38例),安慰剂对照组(0 mg/天,37例)。主要观察指标是初始添加母乳强化剂的天数、肠道喂养达120 ml/kg·day的天数;其次观察指标是每周体重增长情况。结果对比初始添加母乳强化剂的天数,补锌组明显早于安慰剂组,平均早4.088天(95%CI:0.065~8.112,P=0.046)。对比肠道喂养达120 ml/kg·day的天数,补锌组明显早于安慰剂组,平均早4.023天(95%CI:0.324~7.722,P=0.033)。住院期间补锌组比安慰剂组体重平均多增长71.454 g(95%CI:6.733~136.174,P=0.030)。研究期间未发现两组营养液相关不良反应。结论大剂量口服补锌(6 mg/day)可以促进极低出生体重儿肠道喂养和体重增长。Objective Very low birth weight preterm infant have lower zinc reserves than term infants,because ～ 60% of fetal zinc is acquired during the third trimester of pregnancy.Whether oral zinc supplementation promote enteral feeding and bodyweight growth were explored in this clinic study. Methods This was a prospective,double-blinded,randomized,controlled study of very-lowbirthweight preterm neonate randomly allocated on the 10 thday of life to receive（zinc group,6 mg/day） or not receive（control group）oral zinc supplementation between April 2017 and December 2017 in Neonatal Intensive Care Unit（NICU）. The main endpoint was the days needed to attain 120 ml/kg · day enteral feeding and to commence addition of breast milk fortifier. Secondary outcome is bodyweight in every week. Results Compared to placebo control group,the days needed to commence addition of breast milk fortifier was reduced forabout 4 days in zinc group（95% CI： 0. 065-8. 112,P = 0. 046）,the days needed to attain 120 ml/kg·day enteral feeding was reduced forabout 4 days（95% CI： 0. 324-7. 722,P = 0. 033）. Furthermore,the bodyweight growth was about 71. 45 g higher in zinc group（95% CI： 6. 73-136. 17,P = 0. 030）. No adverse events associated with oral supplementations containing zinc or not were observed. Conclusion Oral zinc supplementation promoted enteral feeding and bodyweight growth in very-low-birthweight preterm neonate.

关 键 词：极低出生体重儿 口服补锌 肠道喂养 体重增长 

分 类 号：R722.6[医药卫生—儿科]