晚期早产儿早期静脉补充氨基酸治疗的临床研究

中国儿童保健杂志 ›› 2011, Vol. 19 ›› Issue (9): 786-788.

晚期早产儿早期静脉补充氨基酸治疗的临床研究

孔祥永,刘敬,孔令凯,周伟勤,郑杨,池婧涵,李丽华,商明霞,封志纯

北京军区总医院附属八一儿童医院新生儿科,北京 100700

收稿日期:2011-07-25 发布日期:2011-09-06 出版日期:2011-09-06
通讯作者: 封志纯,E-mail:zhjfengzc@126.com
作者简介:孔祥永(1972-),男,山东人,副主任医师,博士学位,主要研究方向为新生儿危重症的基础与临床

Study on intravenous amino acid administration to late preterm infants directly after birth

KONG Xiang-yong, LIU Jing, KONG Ling-kai, ZHOU Wei-qin, ZHENG Yang, CHI Jing-han, LI Li-hua, SHANG Ming-xia, FENG Zhi-chun

Newborn Care Center, Bayi Children's Hospital, the Military General Hospital of Beijing P.L.A, Beijing 100700, China

Received:2011-07-25 Online:2011-09-06 Published:2011-09-06

摘要/Abstract

摘要： 【目的】评价晚期早产儿(34 ~36⁺⁶周)中,在生后2 h内给予静脉补充氨基酸的效果和安全性。【方法】将115例患儿随机分为两组,治疗组在生后2 h内给予静脉输注氨基酸[2.4 g/(kg·d)],对照组则在生后第1天仅给予输注葡萄糖治疗,在第3天逐渐增加到氨基酸2.4 g/(kg·d)。并动态测定患儿的血气、血糖、BUN及氮平衡情况。【结果】治疗组患儿的BE和HCO^{₃在生后的第2、4天均低于对照组(P<0.05或0.01)。生后第2天血糖监测显示对照组较治疗组偏高(P<0.05)。治疗组生后第2、4天的血尿素氮水平明显高于对照组(P<0.01)。生后第2天,治疗组的氮平衡明显高于对照组(P<0.05),并且对照组呈负氮平衡。【结论】对晚期早产儿早期补充高剂量氨基酸是安全的,使机体处于合成代谢状态,为生长发育所必需。}

关键词: 晚期早产儿, 大剂量氨基酸, 早期

Abstract: 【Objective】 To test the hypothesis that the early administration of amino acids (AA) 2.4 g/(kg·d) to late preterm infants is safe and resultful in a positive nitrogen balance. 【Methods】 A randomized and clinical trial was conducted. Preterm infants with gestational ages between 34W to 36⁺⁶W received either glucose and AA 2.4 g/(kg·d) from birth onward (within 2 hours after birth) (n=56) or solely glucose during the first day with a stepwise increase in AA intake to AA 2.4 g/(kg·d) on days 3 (n=59). Blood gas analysis was performed at admission and in the 2^nd, 4^th postnatal days; blood urea nitrogen levels were determined on the 2^nd day and the 4^thday after birth; nitrogen balances were determined on the 2^nd day and the 4^thday after birth. 【Results】 Modestly altered blood gas values (BE and Bicarbonate) and increased BUN levels with early AA administration in intervention group compared with those in control group (P<0.05 or <0.01 respectively). The infants in the control group had higher glucose level than those in the intervention group at the second day after birth (P<0.05). Nitrogen balance was higher in the intervention group on the 2^nd day after birth as compared with the control group, which had a negative nitrogen balance (P<0.05). 【Conclusions】 High-dose AA administration to late preterm infants can be introduced safely from birth onward and resultful in an anabolic state.

Key words: late-preterm infants, high-dose amino acid administration, early

中图分类号:

R722.6

孔祥永,刘敬,孔令凯,周伟勤,郑杨,池婧涵,李丽华,商明霞,封志纯. 晚期早产儿早期静脉补充氨基酸治疗的临床研究[J]. 中国儿童保健杂志, 2011, 19(9): 786-788.

KONG Xiang-yong, LIU Jing, KONG Ling-kai, ZHOU Wei-qin, ZHENG Yang, CHI Jing-han, LI Li-hua, SHANG Ming-xia, FENG Zhi-chun. Study on intravenous amino acid administration to late preterm infants directly after birth[J]. journal1, 2011, 19(9): 786-788.

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