极早产儿3岁内体格指标追赶生长的特征性研究  

Longitudinal Study of Catch-up Growth Assessed by Anthropometric Parameters in Very Premature Infants within 3 Years Old

作　　者：秦巧稚 赵雪琴[1] QIN Qiaozhi;ZHAO Xueqin(Northern Jiangsu People's Hospital,Yangzhou 225000,China)

机构地区：[1]江苏省苏北人民医院,江苏省扬州市225000

出　　处：《中国全科医学》2022年第8期913-917,923,共6页Chinese General Practice

基　　金：江苏省妇幼保健协会科研项目(FYX202022)。

摘　　要：背景随着围生医学的进步和发展,极早产儿的存活率明显升高。极早产儿生长发育落后会对其产生长远影响,因此早期的追赶性生长极其重要,目前对极早产儿体格指标的长期追踪较少。目的探讨极早产儿3岁内体质量、身长、头围的增长趋势,促进科学追赶生长。方法选取2017年8月至2018年9月在江苏省苏北人民医院新生儿重症监护病房诊治的120例极早产儿(胎龄28~32周)为研究对象,其中小于胎龄儿(SGA)组11例,适于胎龄儿(AGA)组109例,随机抽取同时间段出生的121例足月儿作为对照组。在矫正年龄40周,矫正年龄3、6、12、24月龄,矫正年龄36月龄时进行体质量、身长、头围的测量,计算体格指标Z评分、生长速率。结果SGA、AGA极早产儿组和足月儿组各项体格指标Z评分在矫正12月龄内比较,差异均有统计学意义(P<0.05)。AGA极早产儿组和足月儿组体质量追赶高峰出现在矫正3月龄前,SGA极早产儿组体质量追赶峰值在矫正3~6月龄;AGA极早产儿组和足月儿组身长以矫正6月龄内增长趋势明显,SGA极早产儿组身长在矫正3~6月龄之间出现追赶高峰;AGA极早产儿组头围在矫正3月龄内追赶趋势明显,SGA极早产儿组头围在矫正3月龄后追赶明显,矫正12月龄后逐渐变缓。三组在矫正年龄40周~12月龄的体质量生长速率比较,差异有统计学意义(P<0.05);三组在矫正年龄40周~24月龄的身长及头围生长速率比较,差异均有统计学意义(P<0.05)。结论3岁内SGA极早产儿和AGA极早产儿体格指标追赶趋势有差别,SGA极早产儿各体格指标生长速度早期均落后于AGA极早产儿且追赶速度不均衡。极早产儿早期体格追赶生长与足月儿有明显的差距,组内不同体格指标出现追赶高峰的时间点不同。Background The improvement in perinatal medicine has promoted the increase of survival rate in very premature infants.Since growth and developmental delays will have a long-term impact on them,early catch-up growth is extremely important.However,there are few longitudinal studies on anthropometric parameters for assessing catch-up growth in such infants.Objective To investigate the increasing trend of body weight,body length and head circumference(HC)of very premature infants within 3 years old,providing evidence for promoting scientific catch-up growth in such infants.Methods Participants were selected from Northern Jiangsu People's Hospital during August 2017 to September 2018,including 120 ICUtreated very premature infants delivered at 28-32 weeks of gestation,who were divided into two group〔small for gestational age(SGA)group(n=11)and appropriate for gestational age(AGA)group(n=109)〕,and 121 full-term infants.Body weight and length as well as HC were measured at 40 weeks,3,6,12,24 months of corrected age and 36 months,respectively,and Z-scores and growth rates of these three parameters were calculated.Results The Z-scores of body weight,body length and HC differed statistically across SGA,AGA and full-term infants within 12 months of corrected age(P<0.05).The catch-up growth for weight peaked within 3 months of corrected age in AGA infants and full-term infants,and it peaked within 3 to 6 months of corrected age in SGA infants.The growth for height showed a significant increase trend within 6 months of corrected age in AGA and full-term infants.For SGA infants,the catch-up growth for height peaked within 3 to 6 months of corrected age.The HC of AGA infants had an obvious trend of catch-up growth within 3 months of corrected age,while SGA infants'catch-up growth for HC was obvious after 3 months of corrected age,and it gradually slowed down after 12 months of corrected age.The body weight growth rate varied statistically across SGA,AGA and full-term infants during 40 weeks to 12 months of corrected age(P<0

关 键 词：婴儿 极度早产 小于胎龄儿 适于胎龄儿 Z评分 追赶生长 

分 类 号：R722[医药卫生—儿科]