小于胎龄儿追赶性生长期脂代谢水平动态监测的临床应用  

Study on lipid metabolism of small gestational age infants in catch-up growth

作　　者：常媛媛 古再丽努尔·阿不力孜 江帆 帕提古丽·玉苏普 张羿[2] CHANG Yuanyuan;Guzailinuer·Abulizi;JIANG Fan;Patiguli·Yusupu;ZHANG Yi(Department of Neonatology,General Hospital of Xinjiang Military Command,Urumqi,Xinjiang 830000,China;Department of Clinical Epidemiology Research Institute,Fudan University Affiliated Pedictric Hospital,Shanghai 201100,China)

机构地区：[1]新疆军区总医院新生儿科,新疆乌鲁木齐830000 [2]复旦大学附属儿科医院临床流行病研究所,上海201100

出　　处：《检验医学与临床》2025年第7期957-963,共7页Laboratory Medicine and Clinic

基　　金：“喀喇昆仑”人才基金项目(2022JC006)。

摘　　要：目的动态监测小于胎龄儿(SGA)在追赶性生长期脂代谢水平的表达变化,并探究其临床应用的潜在价值。方法以92例新生儿为研究对象,依据临床诊断标准将SGA 42例纳入SGA组,适于胎龄儿(AGA)50例纳入AGA组。在出生后第1天(d0)、出生后第7天(d7)、出生后第28天(d28),收集各组血清标本,分别采用全自动生化分析仪、酶联免疫吸附试验(ELISA)检测脂代谢相关指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(apoA)、载脂蛋白B(apoB)]和脂代谢调控相关指标[Ghrelin、Nesfatin-1、α-L-岩藻糖苷酶(AFU)],结合临床体征和临床资料分析评估d28时脂代谢水平与SGA生长发育的关系。结果d0时SGA组LDL-C、AFU水平低于AGA组,差异均有统计学意义(P<0.05),而2组TG、TC、HDL-C、apoA、Ghrelin水平在d0时比较,差异均无统计学意义(P>0.05)。d7起,SGA组TG、TC、LDL-C、AFU、Ghrelin水平呈递进式升高,至d28明显高于AGA组,差异有统计学意义(P<0.05);在d28,SGA组虽然体质量仍低于AGA组(P<0.05),但已较d0时有了大幅度的改善,符合SGA追赶性生长预期;其余监测指标apoA、HDL-C和Nesfatin-1水平2组间变化趋势相近,差异均无统计学意义(P>0.05)。结论基于TG、LDL-C、Ghrelin和AFU在SGA追赶性生长期的动态变化,定期联合监测上述指标的表达变化,可为婴幼儿合理的营养摄入、能量供给提供借鉴和参考。Objective To dynamically observe the expression changes of lipid metabolism in small gestational age(SGA)infants during catch-up growth period,and to explore the potential value of its clinical application.Methods A total of 92 newborns were selected as the research subjects,and 42 SGA infants were included in the SGA group according to clinical diagnostic criteria,while 50 infants suitable for gestational age(AGA)were included in the AGA group.On the day of birth,the 7th day of birth and 28th days of birth,serum samples were collected from each group,and lipid metabolism related indicators[triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A(apoA),apolipoprotein B(apoB)]and lipid metabolism regulation related indicators[Ghrelin,Nesfatin-1,α-L-fucosidase(AFU)]were detected using fully automated biochemical analyzer and enzyme-linked immunosorbent assay respectively.The correlation between lipid metabolism levels on the 28th day of birth and the growth and development of SGA infants was analyzed and evaluated based on clinical signs and data.Results On the day of birth,the levels of LDL-C,AFU in the SGA group were lower than those in the AGA group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the levels of TG,TC,HDL-C,Ghrelin and apoA between the two groups on the day of birth(P>0.05).From the 7th day of birth,the levels of TG,TC,LDL-C,AFU and Ghrelin in the SGA group gradually increased,and by the 28th day of birth,they were significantly higher than those in the AGA group,with statistical significance(P<0.05).On the 28th day of birth,although the body mass of the SGA group was still lower than that of the AGA group(P<0.05),there was a significant improvement compared to the day of birth,which met the expectations of SGA catch-up growth.The changes in other observation indicators such as apoA,HDL-C and Nesfatin-1 levels between the two groups showed

关 键 词：小于胎龄儿 脂代谢 追赶性生长 总胆固醇 甘油三酯 

分 类 号：R722.19[医药卫生—儿科]