不同出生体重早产儿2岁内追赶生长特征的纵向研究  

Longitudinal study on the catch-up growth characteristics of preterm infants with different birth weight within 2 years of age

作　　者：张梅[1] 匡晓妮[1] 缪丹[1] 马祺 黄广文[2] ZHANG Mei;KUANG Xiao-ni;MIAO Dan;MA Qi;HUANG Guang-wen(Department of Child Health,Changsha Maternal and Child Health Hospital,Changsha,Hunan 410007,China)

机构地区：[1]长沙市妇幼保健院儿童保健科,湖南长沙410007 [2]湖南省妇幼保健院儿童保健科

出　　处：《中国儿童保健杂志》2022年第10期1136-1140,共5页Chinese Journal of Child Health Care

基　　金：湖南省科技重大专项子项目(2019SK1015);湖南省卫健委课题(20201151)。

摘　　要：目的分析早产儿2岁以内体格追赶生长特征,为早产儿临床干预提供资料。方法选择2017年1月—2019年6月在长沙市妇幼保健院出生至24月龄定期预约随访管理的早产儿为研究对象。采用Z评分法,对早产儿体重、身长和头围进行评估,分组统计各月龄3项指标Z值和增长值、不同Z值水平构成比与追赶生长率,分析小于胎龄儿(SGA)与适于胎龄儿(AGA)早产儿体格追赶生长特点。结果AGA早产儿出生时、1月、18月、24月体重Z值均数,1月、9月、18月、24月身长Z值均数均高于SGA早产儿,24月头围Z值均数高于SGA早产儿(t=1.998~6.383,P<0.05)。两组早产儿体重、身长、头围Z值均数均随月龄增长而增大,追赶速度则随月龄递增而变小,1~6月龄追赶速度最快。两组早产儿体重、身长、头围Z值<-2的百分比均随月龄增长而下降,追赶率则随月龄增长而上升,上升幅度最大的月龄是1~6月。SGA、AGA早产儿体重出现全部追赶生长的月龄分别是18月、12月,身长、头围出现全部追赶生长的月龄均为24月。Z值≥0百分比均随月龄增长呈上升趋势,SGA早产儿体重、身长、头围24月龄时完成追赶生长百分比分别为36.1%、25.0%与22.2%,AGA早产儿24月龄时完成追赶生长百分比分别为57.7%、45.1%与43.7%。结论低出生体重早产儿2岁内体格追赶生长具有先快后慢、体重追赶生长月龄提前等特征,追赶速度最快为1~6月龄。SGA早产儿生长水平落后于AGA早产儿。到24月龄时,除了AGA早产儿体重有超半数完成追赶生长外,其余指标完成追赶生长的个体均未超过半数。Objective To analyze the physical catch-up growth characteristics of preterm infants within 2 years of age,so as to provide data for clinical intervention.Methods Preterm infantswho were born from January 2017 to June 2019 and took regulartook follow-up visits from birth to 24 months of age in Changsha Maternal and Child Health Hospital were enrolled in this study.The Z-score method was used to evaluate the weight,length and head circumference of preterm infants.Z value and the mean increas value of weight,length and head circumference for each month age were calculated by group.The composition ratio of different Z value levels and the catch-up growth rate were analyzed,and the physical catch-up growth characteristics of SGA and AGA preterm infants were analyzed.Results Weight Z value of AGA preterm infants at born,1,18,24 months old,Z value of body length at 1,9,18,24 months and head circumference at 24 months old,were significantly higher than those of SGA preterm infants(t=1.998-6.383,P<0.05).The weight,length and head circumference Z value of AGA and SGA preterm infants all increased with age,while the catch-up speed decreased with age,and the catch-up speed was the highest at the age of 1 to 6 months.The percentage of weight,length and head circumference Z value<-2 decreased with age,and the catch-up rate increased with age.The maximum increase was between 1 and 6 months old.The weight of SGA and AGA preterm infants started to catch up at 18 and 12 months old,respectively,while the body length and head circumference started to catch up at 24 months old.The percentages of Z value≥0 showed an upward trend with the increase of months.The proportions of achieving catch-up growth of weight,length and head circumference till 24 months old in SGA preterm infants were 36.1%,25.0%and 22.2%at 24 months of age,respectively,which were 57.7%,45.1%and 43.7%for AGA preterm infants.Conclusions Low birth weight preterm infants are characterized by fast growth followed by slow growth and early age of weight catch-up growth

关 键 词：追赶生长 Z评分 早产儿 

分 类 号：R722.6[医药卫生—儿科]