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目的观察出生后早期氨基酸摄入对极低和超低出生体重儿纠正胎龄12~20个月时体格、神经发育的影响。方法回顾性分析53例早产儿的临床资料,早期组28例(EAA组),生后24 h内开始给予0.5 g/kg·d静脉氨基酸,晚期组25例(LAA组)生后48 h后开始给予0.5 g/kg·d静脉氨基酸,对比两组住院期间及随访时各项临床指标的差异。结果在纠正胎龄12~20个月时,EAA组和LAA组身长、头围、体重方面无统计学差异(P>0.05),但EAA组比LAA组智力发育指数(MDI)、运动发育指数(PDI)均要高(P<0.05)。早产儿第3天的蛋白质、能量摄入量、第1周平均蛋白摄入量分别与纠正胎龄12~20个月时MDI、PDI均呈正相关。同等胎龄的早产儿,第1周平均每1 g/kg·d蛋白质会增加MDI 13.7分,会增加PDI12.8分。结论在生后早期给予超低和极低出生体重儿足够的热卡和蛋白质摄入对于以后的神经系统和认知功能发育很重要。因此保证早产儿早期营养对减少神经发育不良至关重要。
Objective To observe the effects of early postnatal amino acid intake on the physical and neurodevelopment of children with very low and very low birth weight at 12-20 gestational weeks. Methods The clinical data of 53 preterm infants were retrospectively analyzed. In the early group, 28 cases (EAA group) received 0.5 g / kg · d intravenous amino acids within 24 hours after birth, and 25 cases (LAA group) 0.5 g / kg · d intravenous amino acids were initially administered to compare differences in clinical parameters between the two groups during hospitalization and at follow-up. Results There was no significant difference in body length, head circumference and weight between EAA group and LAA group at 12 to 20 months of gestation (P> 0.05). However, in EAA group, the scores of mental development index (MDI), motor development index (PDI) were higher (P <0.05). The protein, energy intake and average protein intake in the first week of preterm infants were positively correlated with MDI and PDI at 12 to 20 months of gestational age respectively. The average gestational age of premature children, the first week of each 1 g / kg · d protein will increase the MDI 13.7 points, will increase PDI12.8 points. Conclusions Sufficient caloric and protein intake for both very low and very low birth weight infants in the early postnatal period is important for subsequent development of the nervous system and cognitive function. Therefore, to ensure early nutrition in preterm infants to reduce nerve dysgenesis is essential.