论文部分内容阅读
目的探讨早期足量蛋白质摄入对极低出生体重儿(very low brith weight infant,VLBWI)早期生长速率的影响。方法将出生体重1 000~1 500g并治愈出院的61例VLBWI随机分为研究组[n=31,氨基酸2.0g/(kg·d)开始,1.0g/(kg·d)递增]和对照组[n=30,氨基酸0.5~1.0g/(kg·d)开始,0.5g/(kg·d)递增],比较两组蛋白质、能量摄入情况及蛋白/能量比,血生化指标、体格增长及合并症等,并对两组蛋白质和能量摄入及蛋白/能量比与体格增长速率的关系进行相关分析。结果研究组体重下降幅度比对照组低(6.2%vs 9.5%),恢复至出生体重时间比对照组早(6dvs10d)(P均<0.05);平均每周头围增长速率比对照组快[(0.75±0.32)cm vs(0.45±0.25)cm)](P<0.05);每日平均体重增长速率比对照组快[(22.3±3.2)g/kg vs(15.1±2.3)g/kg(P<0.05);平均每周身长增长速率差异无统计学意义(P>0.05)。第3天、第7天总热卡及蛋白质摄入、蛋白/能量比与恢复出生体重后每日平均体重增长速率及平均每周头围增长速率呈正相关(均P<0.05)。两组患儿平均血清总胆汁酸及尿素氮水平差异无统计学意义,但平均白蛋白水平研究组明显高于对照组(P<0.05)。结论早期足量蛋白质摄入能够降低VLBWI出生早期的体重下降幅度,更早恢复至出生体重,加速住院期间的体重及头围增长速度。
Objective To investigate the effect of early adequate protein intake on the early growth rate of very low brith weight infant (VLBWI). Methods Sixty-one VLBWI patients with birth weight of 1 000-1 500 g and discharged from hospital were randomly divided into study group (n = 31, beginning with 2.0 g / (kg · d) amino acid, 1.0 g / (kg · d) (n = 30, amino acid 0.5 ~ 1.0g / (kg · d), 0.5g / (kg · d)). The protein intake, energy intake and protein / energy ratio, blood biochemical parameters, And comorbidities. The correlations between protein and energy intake, protein / energy ratio and body growth rate were also analyzed. Results The body weight loss rate of study group was lower than that of control group (6.2% vs 9.5%), and the body weight of body weight returned to birth weight earlier (6d vs 10d) than that of control group (all P <0.05) 0.75 ± 0.32 cm vs 0.45 ± 0.25 cm, P <0.05). The average daily rate of weight gain was faster than that of the control group [(22.3 ± 3.2) g / kg vs (15.1 ± 2.3) g / kg <0.05). There was no significant difference in average growth rate per week (P> 0.05). On day 3 and day 7, the total daily calorie intake and protein intake, protein / energy ratio were positively correlated with the average daily weight gain rate and the average weekly rate of head circumference increase after birth weight recovery (all P <0.05). The average serum total bile acid and urea nitrogen levels in both groups had no significant difference, but the average albumin level in the study group was significantly higher than that in the control group (P <0.05). Conclusion Early intake of sufficient protein can reduce the weight loss of VLBWI early in life, recover earlier to birth weight, and accelerate the growth of body weight and head circumference during hospitalization.