论文部分内容阅读
目的了解小于胎龄儿(small for gestational age neonates,SGA)早期血脂及脂蛋白代谢特点。方法选择无严重并发症新生SGA 47例为研究对象,以45例足月适于胎龄儿(adequate for gestational age,AGA)作为对照组。于出生后12h内静脉采血,测定血浆总胆固醇(total cholesterol,TC)、甘油三脂(triglyceride,TG),低密度脂蛋白胆固醇(lowdensity lipoprotein cholesterols,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterols,HDL-C)、载脂蛋白(apolipoproteins,apo)A1及apo-B水平,计算LDL-C/HDL-C及apo-B/apo-A1比值;并进一步将SGA根据是否足月、宫内发育迟缓程度(出生体重位于同胎龄平均体重P3以下为SGA1组,P3~P10之间为SGA2组)及性别进行分组,比较上述指标的水平。结果与对照组比较,SGA患儿具有高的TC(2.41±0.61vs 2.11±0.78,P<0.05)、LDL-C(0.90±0.44vs 0.71±0.42,P<0.05)和apo-B(0.40±0.22vs 0.29±0.15,P<0.01)浓度,及高的LDL-C/HDL-C(1.31±1.29vs 0.82±0.46,P<0.05)、apo-B/apo-A1(0.60±0.35vs 0.40±0.19,P<0.01)比值;SGA1组比SGA2组具有低的TC、HDL-C及apoA1水平,而具有高的apo-B/apo-A1比值(P<0.01或<0.05);早产SGA患儿比足月SGA患儿具有低的TG水平(P<0.05);性别对SGA血脂及脂蛋白水平没有影响。结论不良的宫内环境使SGA早期可出现脂质代谢异常,宫内发育迟缓越严重脂质代谢异常越明显,SGA远期可能更易出现心血管疾病;早产SGA血浆TG水平低于足月SGA,可能与新生儿成熟度相关。
Objective To understand the characteristics of early lipid and lipoprotein metabolism in small for gestational age neonates (SGA). Methods Forty-seven newborn SGA patients without serious complications were selected as the study subjects, and 45 full-term suitable gestational age (AGA) as control groups. Blood samples were taken intravenously 12 hours after birth to measure the levels of total cholesterol (TC), triglyceride (TG), lowdensity lipoprotein cholesterols (LDL-C), high density lipoprotein cholesterol HDL-C), apolipoproteins (apo) A1 and apo-B levels were calculated to calculate the LDL-C / HDL-C and apo-B / Month, the degree of intrauterine growth retardation (birth weight is located in the same weight-bearing gestational age below P3 for the SGA1 group, P3 to P10 for the SGA2 group) and gender were grouped to compare the level of these indicators. Results Compared with the control group, children with SGA had high TC (2.41 ± 0.61 vs 2.11 ± 0.78, P <0.05), LDL-C (0.90 ± 0.44 vs 0.71 ± 0.42, P <0.05) and apo-B 0.22 ± 0.29 ± 0.15, P <0.01) and high LDL-C / HDL-C (1.31 ± 1.29 vs 0.82 ± 0.46, P < 0.19, P <0.01). The SGA1 group had lower levels of TC, HDL-C and apoA1 than the SGA2 group and high apo-B / apo-A1 ratio There was a low TG level in children with term SGA (P <0.05); sex had no effect on SGA lipids and lipoprotein levels. Conclusions The intrauterine environment may lead to abnormal lipid metabolism in the early stage of SGA. The more serious the intrauterine growth retardation, the more obvious the abnormal lipid metabolism. The SGA may be more prone to cardiovascular disease in the long term. The plasma TG level of premature SGA is lower than that of term SGA, May be related to neonatal maturity.