不同胎龄早产儿血脂生化指标的临床意义

目的通过测定不同胎龄早产儿血脂生化指标的变化,探讨其作为评价早产儿成熟度、营养状况及营养支持指标的临床意义。方法早产儿组30例在入院后12 h内（出生后24 h）采集股静脉血2 ml,采血前2 h未喂养及输液。足月儿组30例在胎儿娩出、清理呼吸道后即刻采脐带血2 ml。测定血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）等生化指标。结果早产儿组血清TC、TG、HDL-C、LDL-C、ApoA1、ApoB水平均低于足月儿组,2组之间差异具有统计学意义（P〈0.01）。28～31周的早产儿组血清TC、TG、HDL-C、LDL-C、ApoA1、ApoB水平均低于32～36周的早产儿组,2组之间差异具有统计学意义（P〈0.01）。结论血脂生化指标可作为评价早产儿成熟度及营养状况的依据。检测血脂水平变化,对临床合理营养支持具有指导意义。

The clinical significance of biochemical indicators for blood lipids in premature infants at different gestational ages

Objective By measuring the biochemical changes in blood lipids in premature infants of different gestational age,to explore their clinical significance as biochemical indexes to evaluate the maturity,nutritional status and nutritional support in premature infants.Methods 30 premature infants admitted to hospital were designated as the premature group.Blood collection of 2 ml was performed from the femoral vein within 12 hours after admission（24 hours after birth）.2 hours before blood collection,the premature infants received no transfusion or feeding.30 neonates of term delivery underwent blood collection of 2 ml from the umbilical cord immediately after delivery and airway clearance.Determinations were conducted on the biochemical indicators including serum total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,apolipoprotein A1（ApoA1） and apolipoprotein B（ApoB）.Results Serum TC,TG,HDL-C,LDL-C,ApoA1 and ApoB levels in the premature infant group were lower than in the mature neonate group.The results had statistical difference（P0.01）.Serum TC,TG,HDL-C,LDL-C,ApoA1 and ApoB levels in the premature infants of 28-31 weeks were lower than in those of 32-36 weeks.The levels between the two subgroups of premature infants were statistically different（P0.01）.Conclusion Biochemical indicators of blood lipid can be used as evidence of maturity and nutritional status in premature infants and the determination of the variations in the levels of blood lipids plays the role of a reasonable guide to clinical nutritional support.