早期应用氨基酸联合脂肪乳对早产儿体质量、营养状况及代谢的影响

目的:探讨早期高剂量氨基酸联合脂肪乳对早产儿体质量、营养状况及代谢情况的影响。方法:选取2013年1月-2015年1月符合不能耐受全肠道营养条件的早产儿60例,采用数字随机表法随机分为对照组和观察组各30例。对照组出生2d后加用氨基酸、3d加用脂肪乳,观察组出生第1d给予高剂量氨基酸和脂肪乳,记录两组体重、头围增长情况、住院时间及并发症发生率,出生后第1d、7d检测两组营养指标[前蛋白(PA)、视黄醇结合蛋白]及代谢指标[尿素氮(BUN)、剩余碱(BE)、总胆红素(TBIL)、肌酐(SCr)、谷丙转氨酶(ALT)]。结果:观察组住院期间体质量增长速度、头围增长高于对照组,体质量最大下降幅度低于对照组,恢复至出生体质量时间、住院时间短于对照组(均P0.05)。与第1d相比,两组第7dPA、视黄醇结合蛋白均上升(P0.05),且观察组上升幅度高于对照组(P0.05);两组第7dBUN、TBIL、ALT、SCr均上升,BE值下降(P0.05),但两组第7d组间相比无差异(P0.05);观察组并发症发生率(16.7%)低于对照组(40.0%)(P0.05)。结论:早期高剂量氨基酸联合脂肪乳可改善早产儿营养状态,缩短恢复至出生体重时间,但对机体代谢无明显影响。

The impact of amino acid combined with fat emulsion used early on body weight,nutritional status and metabolism of premature infants

Objective:To investigate the impact of high dose of amino acid combined with fat emulsion using early on body weight,nutritional status and metabolism of premature infants.Methods:From January 2013 to January 2015,sixty premature infants who were unable to tolerate total enteral nutritionin were randomized divided into the observation group and the control group (30 cases in each group) by random digital table.The infants in the observation group was given high dose amino acids combined with fat emulsion on the 1st day after birth,and the infants in the control group were given amino acids at 48 h after birth and fat emulsion at 72 h after birth.The status of increase of weight,head circumference,the time of hospitalization and the incidence of complications were compared between the two groups.On the 1st and 7th day after birth,the nutrition indicators of infants were also compared between the two groups,which included prealbumin (PA),retinol conjugated protein and metabolic indices blood urea nitrogen (BUN),base excess (BE),total bilirubin (TBIL),serum creatinine (SCr),alanine aminotransferase (ALT).Resujts:The increase of body weight and head circumference of infants in the observation group during hospitalization were greater than those of infants in the control group,and the maximum body weight loss of infants in the observation group was less than that of infants in the control group.The time of recovering to birth weight and hospitalization time of infants in the observation group were significant shorter than those of infants in the control group (P＜ 0.05).Compared with the situation of infants on the 1st day,PA and retinol conjugated protein of infants in both groups were significant higher than those of infants on the 7th day (P＜ 0.05),and the increase of PA and retinol conjugated protein of infants in observation group were significant higher than those of infants in the control group (P ＜ 0.05).Compared with the situation of infants on the 1st day,BUN,TBIL,ALT and SCr of infants in both groups were significant higher than those of infants on the 7th day (P＜ 0.05),but BUN,TBIL,ALT and SCr of infants on the 7th day had no significant difference between the two groups (P ＞ 0.05).Compared with the situation of infants on the Ist day,BE value of infants in both groups were significant lower than that of infants on the 7th day (P ＜ 0.05),but BE value of infants on the 7th day had no significant difference between the two groups (P＞ 0.05).The incidence of complications of infants in the observation group (16.67％) was lower than that of infants in the control group (40.0％) (P＜ 0.05).Conclusion:High dose amino acid combined with fat emulsion using early can improve the nutritional status of preterm infants and shorten the time of recovering to birth weight,and it has no significant impact on metabolism of the body.