早期应用不同初始剂量氨基酸对早产儿生长发育的影响

目的分析早期不同初始剂量氨基酸的应用对早产儿生长发育的影响。方法选择2011年6月至2012年12月湛江中心医院重症监护室接受监护的120例早产儿作为研究对象,均接受氨基酸等静脉营养治疗,采用随机数字表法分为高剂量组和低剂量组,每组各60例,高剂量组在出生24 h内输入至少2.0 g/kg的氨基酸,之后每日以1.0 g/kg递增,直至达到3.6 g/kg;低剂量组出生后先不输入氨基酸类药物,24 h后开始输入1.0 g/kg的氨基酸,之后每日以0.5 g/kg递增,同样直至达到3.6 g/kg。对两组患儿进行有效性评估和生化、血气指标检测比较。结果高剂量组头围增长(0.94±0.13)cm/周vs(0.82±0.12)cm/周]高于低剂量组,体质量下降百分数(5.03±0.09)%vs(5.65±0.25)%]、达出生体质量时天数(10.5±3.7)d vs(15.3±4.8)d]、体质量达2000 g天数(35.1±11.5)d vs(42.4±8.3)d]低于低剂量组,差异均有统计学意义(P<0.01);入院后1周,高剂量组前白蛋白(198.2±11.5)g vs(170.0±10.5)g],血尿素氮(5.6±0.5)mmol/L vs(4.3±0.4)mmol/L]较低剂量组升高显著,差异均有统计学意义(P<0.01)。结论早期大剂量氨基酸的应用对早产儿生长发育较低剂量氨基酸促进作用更为显著,应在早期对早产儿进行大剂量的氨基酸补充。

The Effects of Early Application of Different Initial Doses of Amino Acids on the Growth and Devel- opment of Premature Infants

Objective To analyze the effects of different initial doses of amino acids on the growth and development of premature infants. Methods A total of 120 cases of premature infants admitted in the inten- sive care unit of Zhanjiang Central Hospital from Jun. 2011 to Dec. 2012 were randomly divided into high doses group and low dose group according to the dose amount received when taking intravenous nutrition therapy such as amino acid, with 60 cases in each group. Infants in the high dose group were treated with at least 2.0 g/kg amino acids within 24 hrs after birth,and a daily 1.0 g/kg increment until 3.6 g/kg was reached. Infants in the low dose group were not treated with any amino acid drug within 24hrs after birth, afterwards treated with 1.0 g/kg amino acids and a daily 0.5 g/kg increment until 3.6 g/kg was reached. The effective- ness, biochemical and blood gas indexes of the two groups were compared. Results The head circumference growth of the high dose group was higher than the low dose group （0.94 ±0.13 ） cm/week vs （0.82 ± 0.12） cm/week] ,the body weight loss percentage of the high dose group was lower than the low dose group （5.03 ± 0.09 ） % vs （ 5.65 ± 0.25 ） % ], same to the number of days when reaching the birth weight （ 10.5 ±3.7） d vs （ 15.3±4.8 ） d ], and the number of days when reaching 2000 g （35.1± 11.5 ） d vs （42.4 ± 8.3 ） d ], the differences between the two groups were statistically signficant （ P 〈 0.05 ）. After one week of hospitalization, the prealbumin level of the high dose group was higher than the low dose group （ 198.2 ± 11.5 ） g vs （ 170.0 ± 10.5 ） g], same to the blood urea nitrogen level （5.6 ± 0.5 ） mmol/L vs （4.3 ± 0.4 ） mmol/L 1, the differences between the two group were statistically signficant （P 〈 0.05 ）. Conclusion Applying large dose of amino acids early in premature infants promotes the growth and development of premature infants more significantly than applying low dose of amino acids. Ther