早产儿早期血脂代谢特点及与新生儿呼吸窘迫综合征关系探讨

目的：了解早产儿早期血脂代谢特点及其与新生儿呼吸窘迫综合征（RDS）的关系。方法：将100例适于胎龄早产儿按胎龄或出生体重分组，并以40例足月适于胎龄儿作为对照组，于出生后12 h内静脉采血，测定血浆总胆固醇（TC）、甘油三脂（TG），低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）水平；另外，分别根据胎龄及出生体重进一步比较发生RDS与未发生RDS早产儿的血脂水平。结果：随胎龄及体重增加，TG水平呈递增趋势，28~30周组及31~33周组早产儿血浆TG水平均明显低于34~36周早产儿及足月儿（P<0.01）；出生体重≤1499 g组及1500~2499 g组早产儿血浆TG水平均明显低于出生体重≥2500 g早产儿及足月儿（P<0.05），且出生体重≤1499 g组与1500~2499 g组早产儿之间TG水平差异亦有统计学意义（P<0.01）；而各组新生儿HDL-C、LDL-C及TC水平差异无统计学意义。RDS与非RDS早产儿血浆TC、LDL-C及HDL-C水平差异亦无统计学意义；但在胎龄28~30周组，RDS早产儿的TG水平比非RDS早产儿明显降低（P<0.05）；体重≤1499 g RDS早产儿TG水平低于非RDS早产儿（P<0.05）。结论：早产儿血脂水平与胎龄及体重相关，低TG水平可能是胎龄28~30周及体重≤1499 g早产儿出现RDS的原因之一。

Relationship between early serum lipid profiles and respiratory distress syndrome in preterm infants

OBJECTIVE: To investigate early serum lipid profiles in preterm infants and their relationship with neonatal respiratory distress syndrome (RDS). METHODS: Appropriate-for-gestational-age (AGA) preterm infants were grouped according to gestational age (GA) or birth weight (BW). AGA full-term infants were randomly selected as the control group. Venous blood samples were collected within 12 hours after birth for measurement of biochemical indices, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG). Blood lipid levels were compared between preterm infants with and without RDS in various groups. RESULTS: Plasma TG level rose as GA and BW increased. Plasma TG levels in the 28-30 week and 31-33 week GA groups were significantly lower than in the 34-36 week GA and control groups (P<0.01). Plasma TG levels in the ≤1499 g and 1500-2499 g BW groups were significantly lower than in the ≥2500 g BW and control groups (P<0.05), and the 1500-2499 g BW group had a significantly higher plasma TG level than the ≤1499 g BW group (P<0.01). There were no significant differences in plasma HDL-C, LDL-C and TC levels between all groups and between preterm infants with RDS and without RDS. In the 28-30 week GA group, the preterm infants with RDS had a significantly lower TG level than those without RDS (P<0.05); also, in the ≤1499 g BW group, preterm infants with RDS had a significantly lower TG level than those without RDS ( P<0.05). CONCLUSIONS: Blood lipid levels are related to GA and BW. Low TG level may be one of the causes of RDS in preterm infants with a gestational age of 28-30 weeks and a BW of ≤1499 g.