中国儿童保健杂志 ›› 2019, Vol. 27 ›› Issue (11): 1243-1246.DOI: 10.11852/zgetbjzz2019-0282

• 经验交流 • 上一篇    下一篇

不同随访模式早产儿生后6至12月营养相关指标的对比研究

吕奎林, 余秀梅, 杨张娅, 杨望, 张雨平   

  1. 陆军军医大学第二附属医院儿科,重庆 400037
  • 收稿日期:2019-03-12 发布日期:2019-11-10 出版日期:2019-11-10
  • 通讯作者: 张雨平,E-mail:465616386@qq.com
  • 作者简介:吕奎林(1981-),男,四川人,主治医师,本科学历,主要研究方向为新生儿及早产儿生长发育和早期干预。
  • 基金资助:
    重庆市科委社会与民生项目(cstc2017shmsA130013);第三军医大学第二附属医院临床科研项目重点项目(2014YLC09)

Comparative study on nutrition-related indicators in preterm infants with different follow-up    patterns from 6 to 12 months after birth

LYU Kui-lin, YU Xiu-mei, YANG Zhang-ya, YANG Wang, ZHANG Yu-ping   

  1. Department of Pediatrics,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China
  • Received:2019-03-12 Online:2019-11-10 Published:2019-11-10
  • Contact: ZHANG Yu-ping,E-mail:465616386@qq.com

摘要: 目的 监测规律随访与未规律随访模式早产儿生后6~12月间(矫正月龄)血清25-羟维生素D3[25-(OH)D3]、钙(Ca)、磷(P)、碱性磷酸酶(ALP)、尿素(UREA)、前白蛋白(PA)的水平,探讨两种随访模式对早产儿营养状况的影响及其安全性。方法 回顾性分析2015年1月-2017年12月在陆军军医大学第二附属医院院门诊就诊的143例早产儿资料,其中定期规律随访者79例设为A组,另外因各种原因未能定期规律随访者64例设为B组,同时将同期在本院儿保门诊随访的足月健康婴儿253例设为C组。婴儿于出生第6月至第12月(早产儿为矫正月龄)间抽血查血清25-(OH)D3、Ca、ALP、P、UREA、PA水平。结果 1)A组及C组的血清25-(OH)D3、Ca、PA均显著高于B组(P<0.05)。A组的血清25-(OH)D3高于C组,差异具有统计学意义(P<0.05)。A、B、C三组间血清ALP、P、UREA差异无统计学意义(P>0.05)。2)A、B、C三组25-(OH)D3测值评价结果比较:三组均无中毒病例,评价为25-(OH)D3值适宜的例数A组最多,B组最少。结论 1)定期规律随访并按儿保建议喂养的早产儿,其生后6至12月血清25-(OH)D3缺乏及低前白蛋白血症发生率低。2)早产儿喂养方案需个体化。3)部分早产儿营养评价指标(如:ALP)缺乏参考标准,仍需完善。

关键词: 早产儿, 25-羟维生素D3, 钙, 磷, 碱性磷酸酶, 尿素, 前白蛋白

Abstract: Objective To monitor serum 25-hydroxyvitamin D3 [25-(OH)D3],calcium(Ca),phosphorus (P),alkaline phosphatase (ALP),urea(UREA),prealbumin (PA) of regular and irregular follow-up model of premature infants from corrected age of 6 to 12 months after birth,so as to explore the effect of two follow-up models on nutritional status of premature infants and the safety. Methods A retrospective analysis of 143 premature infants in the Second Affiliated Hospital of Army Medical University from January 2015 to December 2017 was conducted.Totally 79 premature infants undergoing regular follow-up were assigned to group A,and 64 premature infants undergoing unscheduled follow-up were selected as group B.In the meantime,253 full-term healthy infants followed up in the pediatric care clinic were assigned to group C.Serum level of 25-(OH)D3, Ca,ALP,P,UREA and PA were tested at the corrected age of 6 months to 12 months. Results 1) Serum 25-(OH) D3,Ca and PA in group A and group C of premature infants were significantly higher than those in group B (P<0.05).Serum 25-(OH) D3 in group A was significantly higher than that in group C (P<0.05).But there were no significant differences on serum ALP,P and UREA among group A,B and C.2) There were no poisoning cases of 25-(OH)D3 in three groups.The most suitable 25-(OH)D3 levels were found in group A and the least in group B. Conclusion 1) The incidence rates of serum 25-(OH)D3 deficiency and hypoprealbuminemia are lower in preterm infants regularly followed up and fed according to the recommendation of child care.2) The feeding scheme for premature infants is supposed to be individualized.3) Some nutritional indicators of premature infants,such as alkaline phosphatase,lack reference criteria and need to be improved.

Key words: prematureinfants, 25-hydroxyvitaminD3, calcium, phosphorus, alkalinephosphatase, urea, prealbumin

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