Early individualised parenteral nutrition for preterm infants

Considerable effort should be made to optimise parenteral nutrition of preterm infants in order to limit the development of postnatal growth restriction. A monocentric before-and-after study design was used to determine the effects of computerising parenteral nutrition ordering on the composition of parenteral nutrition (PN) solutions and early clinical outcomes of preterm infants born < or =28 weeks of gestation. Parenteral protein intake during the first week of life and parenteral lipid, glucose and energy intakes during the first and second week of life were significantly higher in infants assessed after the introduction of computerised parenteral nutrition ordering. This led to a significant reduction in the cumulative energy deficit over the first 28 days of life and to an improvement in both early growth and pulmonary outcome. Computerising the PN ordering process improves the nutrient content of the PN solutions and early postnatal outcome.     

Insulin-like growth factor I (somatomedin C) in premature infants on total parenteral nutrition. Relations with nutritional status and protein-energy intakes]

Insulin-like growth factor I (IGF I) is like prealbumin and transferrin a marker of nutritional status. Its level increases with gestational age. The levels of IGF I (96 times), transferrin (86 times) and prealbumin (69 times) were measured in blood samples from 26 premature infants aged 8 to 78 days (gestational age: 28 to 34 weeks, birth weight: 840 to 1,800 g). At the time of sampling, all the infants were on total parenteral nutrition (360 +/- 42 kJ/kg/day and 2.5 +/- 0.3 g of proteins/kg/day). The results were analysed with reference to anthropometric parameters (weight, height, head circumference, skinfolds and arm circumference). There was no correlation between plasma IGF I and anthropometric measurements. There were significant correlations between IGF I and transferrin (p less than 0.01), prealbumin (p less than 0.05), protein intake (p less than 0.01) an energy intake (p less than 0.05). Plasma IGF I increased at the end of the first week of parenteral nutrition in all the 5 infants having initial low values. The plasma IGF I was not correlated with the duration of parenteral nutrition in the 26 infants after the second week of nutrition. IGF I measurement is useful for evaluating the protein nutritional status of premature infants on total parenteral nutrition.     

Evaluation of standardized versus individualized total parenteral nutrition regime for neonates less than 33 weeks gestation

OBJECTIVE: To evaluate the difference in nutrient intakes and biochemical responses in newborn infants <33 weeks gestation who received standardized versus individualized total parenteral nutrition (TPN) regimes. METHOD: Comparison of nutrient intakes and daily biochemical responses in newborn infants <33 weeks gestation who received standardized regime versus those who received individualized TPN regimes from day 2 to day 7 of life. RESULTS: Twenty-seven infants in the standardized TPN group and 31 infants in the individualized TPN group were compared. There were no statistically significant differences (P > 0.05) between the two groups in gestation, birthweight, Clinical Risk Index for Babies scores, daily TPN volume intake and biochemical responses. Infants in the standardized TPN group received less sodium (P < 0.01) and no potassium on day 2 as required, more protein (P < 0.02) every day, and more calcium and phosphate (P < 0.02 from day 4). CONCLUSION: There were no significant clinical and statistical differences in biochemical responses in newborn infants <33 weeks gestation who received standardized versus individualized TPN regimes during the first week of life. The economic cost of TPN provision using standardized TPN formulation was approximately 30% lower.     

Incidence and risk factors of parenteral nutrition‐associated liver disease in newborn infants

Background: The aim of the present study was to determine the incidence and risk factors of parenteral nutrition‐associated liver disease (PNALD) in neonates. Methods: A 1 year prospective cohort study was carried out at the neonatal intensive care unit and sick neonatal wards, Chiang Mai University Hospital. Newborns >1000 g, receiving >7 days of parenteral nutrition (PN), were enrolled. Liver function tests were done by the end of first, second, and fourth week, and then every 4 weeks until the PN was discontinued and the jaundice resolved. The diagnosis of PNALD relied on a history of PN, direct bilirubin >2 mg/dL, and exclusion of other causes of neonatal cholestasis. Selected patient factors and PN compositions were analyzed to determine the risks for development of PNALD. Results: A total of 24 infants with a mean gestational age and birthweight of 32.5 weeks and 1840 g were enrolled. Eight of the 24 developed PNALD. Compared to those without PNALD, gastrointestinal surgery, duration of enteral starvation, duration of PN, maximum PN caloric intake, and maximum carbohydrate intake were significantly associated with the development of liver disease. Despite the lack of statistical significance, there was a trend towards cholestasis in patients with sepsis. Elevation of direct bilirubin was the earliest biochemical change, observed in the first week after PN, followed by increased transaminases. Conclusion: Gastrointestinal surgery, duration of enteral starvation, duration of PN, maximum caloric and carbohydrate intake in PN were significant risks of PNALD in newborn infants.     

Aggressive parenteral nutrition in sick very low birth weight babies: A randomized controlled trial

Survival of preterm neonates in developing world has improved. Developing countries lag behind in nutritional management in NICU especially parenteral nutrition (PN). This randomized controlled trial was done to evaluate the effect of aggressive parenteral nutrition on nitrogen retention of sick VLBW and extremely low birth weight (ELBW) babies. From September 2009 to February 2010, total 34 babies were randomized to receive aggressive parenteral nutrition (APN) (n=17) or standard parenteral nutrition (SPN) (n=17). The average daily total and PN calory intake of babies in APN group was significantly higher during first week. APN was well-tolerated; however, nitrogen retention was not significantly higher in APN group. Aggressive parenteral nutrition in sick VLBW babies is feasible in developing world, though it did not improve nitrogen retention in first week of life.     

Ernährung des Frühgeborenen in den USA

This delineation of nutritional practices pertaining to small premature infants (birth weight <1300 g) is largely based on the authors' experience at the University of Iowa. At Iowa, parenteral nutrition is routinely used in all small premature infants. It is nearly always started on the first day of life and is continued for an average of 20 days. Starting doses of amino acids and lipids are 1.5 and 1.0 g/kg/d, respectively. Enteral nutrition using expressed breast milk (about 85% of infants) or special formulas is initiated during the first few days of life and is advanced very cautiously. Full feedings are reached on average at 26 days of age. During the growth phase, breast milk is always fortified with a commercial fortifier. Because infants are frequently fluid-restricted, high caloric density feedings (90 kcal/dl or 100 kcal/dl, 3771 kJ/l or 4190 kJ/l) are frequently used. Regular monitoring of dietary intake and growth of all infants is performed by the neonatal dietitian.Average intakes of energy and protein as well as growth for 1994/95 and 1999 show substantial increses of energy and protein intakes as well as weight gain during the lastter period, especially during the first two weeks of life. After discharge from the hospital formula-fed infants receive specialized post-discharge formulas. However, for the infant going home breastfeeding no universally accepted method of nutrient supplementation is available.     

Association between early parenteral nutrition and the development of bronchopulmonary dysplasia in preterm infants北大核心CSCD

目的分析生后1周未能肠内营养的胎龄<32周早产儿肠外营养素摄入情况与支气管肺发育不良(bronchopulmonary dysplasia,BPD)发生的关系。方法回顾性收集2017年10月—2022年8月出生并于生后24 h内转入苏州大学附属儿童医院新生儿重症监护病房、胎龄<32周、生后第1周营养摄入完全依靠肠外营养的早产儿作为研究对象,包括79例BPD患儿和73例非BPD患儿。比较两组早产儿住院期间的临床资料。结果BPD组生后体重下降超过10%、宫外生长发育迟缓、胃肠外营养相关性胆汁淤积的患儿比例较非BPD组高(P<0.05),出生体重恢复时间、达完全肠内营养时间、出院时纠正胎龄均大于非BPD组(P<0.05),而纠正胎龄36周时体格发育Z评分低于非BPD组(P<0.05)。BPD组生后1周内液体摄入量高于非BPD组(P<0.05),而热卡摄入量低于非BPD组(P<0.05);BPD组生后1周内氨基酸、葡萄糖、脂质的起始剂量及其摄入总量均低于非BPD组(P<0.05);BPD组生后第3天的糖脂比高于非BPD组,生后第7天的热氮比和糖脂比均高于非BPD组(P<0.05)。结论BPD患儿生后1周内氨基酸和脂质的摄入量及其所提供的热卡占总热量的比例低于非BPD患儿,提示早期肠外营养素摄入与BPD的发生可能有关。     

Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants

AIMS—To improve energy intake in sick very low birthweight (VLBW) infants; to decrease growth problems, lessen pulmonary morbidity, shorten hospital stay, and avoid possible feeding related morbidity. Morbidity in VLBW infants thought to be associated with parenteral and enteral feeding includes bronchopulmonary dysplasia, necrotising enterocolitis, septicaemia, cholestasis and osteopenia of prematurity.METHODS—A prospective randomised controlled trial (RCT) comparing two types of nutritional intervention was performed involving 125 sick VLBW infants in the setting of a regional neonatal intensive care unit. Babies were randomly allocated to either an aggressive nutritional regimen (group A) or a control group (group B). Babies in group B received a conservative nutritional regimen while group A received a package of more aggressive parenteral and enteral nutrition. Statistical analysis was done using Student''s t test, the Mann-Whitney U test, the χ² test and logistic regression.RESULTS—There was an excess of sicker babies in group A, as measured by initial disease severity (P <0.01), but mean total energy intakes were significantly higher (P <0.001) in group A at days 3 to 42 while receiving total or partial parenteral nutrition. Survival and the incidences of bronchopulmonary dysplasia, septicaemia, cholestasis, osteopenia and necrotising enterocolitis were similar in both groups. Growth in early life and at discharge from hospital was significantly better in babies in group A. There were no decreases in pulmonary morbidity or hospital stay.CONCLUSION—Nutritional intake in sick VLBW infants can be improved without increasing the risk of adverse clinical or metabolic sequelae. Improved nutritional intake resulted in better growth, both in the early neonatal period and at hospital discharge, but did not decrease pulmonary morbidity or shorten hospital stay.     

早产儿低出生体重儿两种静脉营养方式的对比研究

目的：静脉营养已经成为低出生体重儿现代综合治疗中不可缺少的一环,对于早产儿静脉营养时何时加用氨基酸和脂肪乳,国内外有很大差别,国内传统静脉营养法为生后48h后加用氨基酸,72h后加用脂肪乳,而国外早期静脉营养法为生后第1天即给予氨基酸和脂肪乳。该实验对比研究两种静脉营养方法的效果。方法：将40例不能耐受全肠道营养的符合条件早产儿低出生体重儿随机分为两组,实验组采用早期静脉营养法,对照组采用传统静脉营养法,记录两组患儿生后1周内营养摄入及2周内体重增长情况、过渡到全肠道喂养时间、静脉营养相关并发症,并于生后第1,3,7天采静脉血测血清前白蛋白。对其中21例(实验组11例,对照组10例)于生后6个月测量身长和体重。结果：①实验组生后1周内每日摄入的非蛋白热卡量、2周内平均每日增重均高于对照组(P<0.001);②相同日龄血清前白蛋白检测结果:第1天实验组与对照组无差异;第3日及第7日实验组均高于对照组,分别为(61±11.2mg/Lvs31.5±8.5mg/L;91.5±10.8mg/Lvs78±10.9mg/L,P<0.001);③实验组与对照组过渡到全肠道喂养时间无差异;④两组均无静脉炎、血栓形成、氮质血症、高脂血症及胆汁淤积的发生,两组呼吸暂停、高血糖、高胆红素血症的发生率差异无显著性(P>0.05)。随访生后6个月的体重,实验组高于对照组,但无统计学意义(P>0.05)。结论：早产儿低出生体重儿采用早期静脉营养比传统静脉营养摄入热卡多,体重增长快;可以避免早产儿早期营养不良的发生;对胃肠功能的恢复无明显作用;不会增加静脉营养相关并发症的发生。     

早期足量胃肠道外营养对早产儿出院时体重的影响

目的探讨早期足量胃肠道外营养对早产儿出院时体重的影响。方法将我院收治的适于胎龄的存活低出生体重早产儿256例随机分为两组,各128例,治疗组应用早期足量胃肠道外营养,对照组应用传统新生儿胃肠道外营养。计算两组患儿各营养指标及出院时宫外生长发育迟缓(EUGR)的发生率,进行统计学分析。结果治疗组除生后第7天热卡与对照组相比 (P>0．05)无显著性差异外,其他各营养指标,如生后体重下降幅度、恢复至出生体重时间、每天体重增长克数、经胃肠达到摄入标准时间、应用胃肠道外营养天数、生后第3天热卡、平均住院天数等均优于对照组(P<0．01),具有非常显著性差异;治疗组出院时发生EUGR 60例,发生率为 46．9％,对照组出院时发生EUGR 87例,发生率为68．0％(x2=11．65,P<0．01),具有非常显著性差异。结论早期足量胃肠道外营养,可减少早产低出生体重儿或极低出生体重儿EUGR的发生率,为今后实现追赶性生长打下良好基础,且未见有严重副作用,值得临床推广应用。     

早产儿间断鼻十二指肠喂养和鼻胃管喂养时血清前白蛋白的变化

目的：早产儿存活率逐年提高,其生后早期经肠道喂养日益受到关注,目前国内普遍采用鼻胃管喂养。鼻十二指肠喂养有争议。该文比较早产儿生后早期间断鼻胃管喂养和鼻十二指肠喂养营养摄入量、生长情况、喂养相关并发症及血清前白蛋白的变化。方法：40例早产儿(出生体重1050g～1920g)随机分为间断鼻胃管喂养组和鼻十二指肠喂养组,用同一种配方乳喂养。记录喂养1周的入液量、热能、蛋白质摄入量;体格生长指标(体重、身长、头围)的变化;大便性状;喂养相关并发症。喂养前和喂养后1周用ELISA法测血清前白蛋白(PA)。结果：喂养后1周鼻十二指肠喂养组较鼻胃管喂养组平均进奶量、热能、蛋白质摄入量均显著增加(P＜0.01＝。肠道营养热能每日达 418.4 kJ/kg 的时间、恢复出生体重的时间明显缩短(P＜0.05＝;两组早产儿喂养前及1周后身长、头围的差异均无显著性(P＞0.05)。喂养前两组PA差异无显著性(P＞0.05);喂养1周后胃十二指肠喂养组的PA明显增加(P＜0.05＝。两组均无腹泻、坏死性小肠结肠炎发生;鼻十二指肠喂养组吸入性肺炎、呕吐、残留的发生率与鼻胃管喂养组比较差异无显著性(P>0.05),高胆红素血症发生率较后者显著减少(P＜0.01＝。结论：生后早期鼻十二指肠喂养儿营养摄入量显著增加,喂养相关并发症减少,营养状态优于鼻胃管喂养儿。     

Is additional oral phosphate supplementation for preterm infants necessary: an assessment of clinical audit

Adequate phosphate intake is important for the prevention of metabolic bone disease in preterm infants. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends a daily phosphate intake of 184–230 mg/kg/day, which should be met by standard feed volumes of either commercially fortified breast milk or preterm formulae. We sought to investigate whether our local practise of providing supplemental oral phosphate for all infants born before 32 weeks’ gestation continues to be necessary. Details of parenteral and milk feeding and both oral and parenteral phosphate supplementation from birth until 8 weeks of age were collected retrospectively from the case notes of 31 preterm infants. Routinely collected biochemical markers of bone mineral status were also recorded. Mean (SD) plasma phosphate concentration was higher when oral phosphate supplementation was given [2.10 (0.38) versus 1.92(0.50)?mM/L without supplement (p?<?0.001)]. A minimum average phosphate intake of 184 mg/kg/day was achieved by 47 and 77 % of babies in weeks 1 and 2, respectively, and by 84–100 % of infants from week 3. The percentage of plasma phosphate measurements below the minimum target of 1.8 mM/L was greater amongst unsupplemented babies (45 versus 18 %). Conclusion: A majority of infants <32 weeks’ gestation did not achieve the recommended phosphate intake during the first week of life. Despite achieving the recommended phosphate intake from week 3, many infants did not have plasma phosphate concentrations within the accepted normal range. Additional oral supplementation may help to achieve blood phosphate concentrations within this target range.     

谷氨酰胺在早产儿肠外营养中的应用研究

目的研究谷氨酰胺(Gln)对早产儿的生长发育、胃肠功能成熟及感染发生率的影响。方法将35例早产儿分为两组,Gln组给予经静脉添加Gln的肠外营养(PN),对照组常规 PN,PN时间均大于2周。监测两组生长发育、喂养耐受情况、胃肠功能及感染发生率。结果 Gln 组生后4周时尿素氮(BUN)水平较对照组高(P=0．044),但仍在正常范围内。平均PN及平均住院时间Gln组均明显短于对照组(P=0．031;P=0．020)。血清胃动素水平Gln组生后2周较生后 3天明显升高(P=0．037);Gln组生后2周较生后3 d胃电节律中节律过快的百分数明显增加 (P=0．017)。Gln组发生感染的次数较对照组明显减少(P=0．001)。结论初步观察提示Gln 有助于早产儿胃肠功能的成熟,减少院内感染的发生。     

早产儿胃肠外营养相关性胆汁淤积的治疗现状

胃肠外营养是救治早产儿及危重新生儿的重要措施.近年来,随着围生期抢救技术的提高,越来越多的早产儿得以存活,极低出生体重儿、超低出生体重儿逐渐成为新生儿疾病谱的重要组成部分。这些早产儿常有胃肠道发育不成熟或合并其他疾病,在出生后的相当长一段时间内需要部分或完全的胃肠外营养支持。由于胃肠外营养的使用,为此类患儿提供了生存机会,大大降低了病死率,但其引起的胃肠外营养相关性胆汁淤积,则成为早产儿的主要并发症之一,严重影响患儿的生存质量。该文就早产儿胃肠外营养相关性胆汁淤积的治疗现状作一综述。     

静脉补充谷氨酰胺对外科手术新生儿喂养耐受的影响

目的 评价含丙氨酰谷氨酰胺(Ala-Gin)肠外营养(PN)对接受外科手术新生儿喂养耐受的影响.方法 对两家儿童医疗中心2006年1月至2007年1月收治的40例接受外科手术的新生儿进行研究,采用平行、随机、双盲、对照实验,随机分为常规PN组(对照组)和常规PN+Ala-Gln组(研究组),二组各20例,对照组氨基酸的剂量为2～3g·kg-1·d-1;研究组添加0.3g·kg-1·d-1 Ala-Gln双肽,其中Ala-Gln双肽取代了处方中相应氨基酸的量.首要终点指标为术后开始喂养时间,术后达到全肠内喂养天数(标准配方摄入量≥120 ml·kg-1·d-1)、完全脱离肠外营养时间和病死率.结果 研究组和对照组比较,患儿术后开始喂养时间[研究组(8±4)d,对照组(8±5)d]、术后达到全肠内喂养天数[研究组(14±8)次,对照组(15±7)次]以及完全脱离肠外营养时间[研究组(15±8)d,对照组(16±7)d]差异均无统计学意义.对照组有3例死亡,研究组患儿无死亡,病死率通过非意向性分析,二组比较差异有统计学意义,OR值为0.789,95%CI为0.626～0.996.但是通过意向性分析,OR值为0.706,95%CI为0.136～3.658,病死率比较差异没有统计学意义.结论 本研究显示,静脉补充谷氨酰胺未能使接受外科手术的新生儿减少术后开始喂养时间和术后达到全肠内喂养天数,缩短全肠外营养应用时间;但关于是否能够降低患儿病死率,通过意向性分析和非意向性分析的结果有差异,尚需进一步研究.     

我国早产儿营养研究现状的可视化研究

目的：生长发育不良将造成神经系统的不良预后事件,而生后不适当的营养供给是造成生长发育不良的重要因素。本研究采用共词分析法对我国早产儿营养的研究现状进行分析,展现我国近六年该领域的研究情况,描绘我国早产儿营养的研究趋势,为未来的研究提示可能的研究方向。方法：于2013年1月以主题词“早产儿”及“营养”在CNKI数据库进行文献检索及筛选,命中文献772篇,使用Excel 2010提取高频关键词并建立共现矩阵,最后使用Ucinet 6.0绘制可视化网络。结果：通过我国早产儿营养支持研究的知识图谱可以看出,我国早产儿营养支持方式的关注热点仍以静脉营养与胃肠内营养相结合为主,其目的是维持早产儿适宜的生长发育速率。在临床营养支持过程中,静脉营养的并发症受到了研究者的高度重视;而喂养不耐受依然是早产儿营养支持特别是胃肠内营养所面临的主要问题。结论：初步建立了我国早产儿营养研究现状的可视化网络并据此进行了知识图谱的绘制,反映了近年来该研究领域的热点及现状。     

中国新生儿营养支持临床应用指南

该指南目的是建立能够反映当前最佳临床实践,循证的营养支持指南,为临床实践和进一步的临床研究方向提供参考。该指南参考了大量已发表的相关文献,在此基础上,由来自各相关学科的多位专家起草、审阅并反复修改而成。目标人群为早产儿、低体重出生儿等危重新生儿。指南分为肠内营养、肠外营养、肠内肠外营养联合应用三部分。当经口喂养无法满足患儿需要量时,应给予肠内或肠外营养支持。如果患儿存在胃肠道功能障碍,肠外营养是唯一选择。指南最后给出了肠内肠外营养联合应用的计算公式。     

Early enteral feeding in very low birth weight infants

Background/aim

Debate exists about when to initiate enteral feeding (EF) in very low birth weight (VLBW) preterm infants. This retrospective study compared the effectiveness of an education-based quality improvement project and the relationship of time of the first EF to necrotizing enterocolitis (NEC) or death incidence and parenteral nutrition (PN) days in VLBW infants.

Study design/subjects

VLBW infants born in 2 epochs were compared for hour of the first feed, PN days, NEC or death incidence, and feeding type. The 2 epochs were temporally divided by a quality improvement initiative to standardize initiation of EF in postnatal hours 6–24.

Results

603 VLBW infants were included. Median time of feed initiation decreased from 33 (Epoch 1) to 14 h (Epoch 2) (p < 0.0001). Median PN days were 14 vs. 12, respectively (p = 0.07). The incidence of NEC or death was 13.4% vs. 9.5%, respectively (p = 0.14). When controlling for birth weight, gestational age, race, gender, and time period, earlier feed initiation was associated with decreased NEC or death (p = 0.003). Evaluation of the relationship of early EF (defined as within the first 24 h) in Epoch 2 alone showed that early EF was significantly associated with decreased NEC or death (6.3 vs 15.1%) (RR, 95% CI = 0.28, 0.13–0.58) and less PN days (p < 0.0001).

Conclusions

In a VLBW infant cohort, an education-based process improvement initiative decreased time of EF initiation to a median of 14 h with no associated increase in NEC or death. In fact, results suggest that earlier feeding is associated with decreased NEC or death.     

前白蛋白在早产低出生体质量儿肠道外营养治疗中的意义

Objective To study the role of serum prealbumin in nutritional treatment of low birth weight premature infants of parenteral nutrition.Methods A total of 61 eases of low birth weight premature infants were divided into two groups: partial parenteral nutrition group(PPN group) and total parenteral nutrition group (TPN group). We detected the levels of serum prealbumin and albumin at the age of 20 hours and 7 days after birth of all infants respectively, at the same time,we observed the infants with body weight change and total caloric intake. Results Before the application of parenteral nutrition,the serum levels of prealbumin were(88.0 ± 9.1)mg/l in PPN group and (87.0± 8.7)mg/l in TPN group, and there were no significant difference between two groups(P > 0.05). Prealbumin levels of PPN group at the 7th day after birth were significantly higher than those of TPN group, which were (128.0 ± 10.8)mg/l in PPN group and (106.0 ± 10.9)mg/l in TPN group(t = 2.67, P < 0.05), and the serum levels of albumin between two groups were not significantly different.The body weight of PPN group was (1832 ± 185)g,close to or regain birth weight,and the body weight of TPN group was significantly lower than birth weight (t = 8.27, P < 0.01).The caloric intake of PPN group was significantly higher than that of TPN group (t = 2.81, P < 0.05) . Conclusion Prealbumin can better reflect the recent nutritional level than the albumin,and can act as the sensitive indicator for monitoring nutritional status of protein.     

早期蛋白质和能量摄入对早产儿生长影响的研究

目的：探讨出生后早期蛋白质和能量摄入对早产儿早期生长速率的影响。方法：采用回顾性研究的方法,收集出生体重小于1800 g并治愈出院的164例早产儿的临床资料,记录早产儿一般情况、肠内外营养支持及体格增长情况。按氨基酸应用起始日的不同分为24 h内应用氨基酸组（EAA组,n=112）和24 h后应用氨基酸组（LAA组,n=52）,比较两组早产儿在住院期间的蛋白质和能量摄入、蛋白/能量比及体格增长速率,并对两组早产儿的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：EAA组的早产儿体重下降幅度比LAA组低（6.3% vs 8.8%）,恢复至出生体重时间比LAA组早（7 d vs 9 d）;每周头围增长速率比 LAA组快（0.79±0.25 cm vs 0.55±0.25 cm）;每日平均体重增长速率比LAA组快（20±3 g/kg vs 17±3 g/kg)。相关分析表明,早产儿第3天及第7天的蛋白质和能量摄入及蛋白/能量比与住院期间平均体重增长速率均呈正相关。恢复出生体重后每周的蛋白质和能量摄入与每周体重增长速率呈多元线性相关（r=0.709,P<0.01）。早产儿第3天及第7天的蛋白质摄入与早产儿头围增长速率及身长增长速率呈正相关。结论：早期应用氨基酸能够降低早产儿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。在适宜能量摄入相对固定的情况下,在一定范围内提高蛋白质摄入量能够增加早产儿的体重、头围及身长的增长速率。