新生儿营养指标评价的临床意义

目的：寻找新生儿营养评价的生化指标。方法：以放射免疫分析法测定血清胰岛素样生长因子I（IGF－1），以酶联免疫吸附法测定视黄醇结合蛋白（RBP）和前白蛋白（PA），分别按新生儿出生体重标准，把研究对象分成小于胎龄儿（SGA）和适于胎龄儿（AGA）进行分析比较。结果：营养不良的32例SGA的IGF－1、RBP和PA的水平明显低于35例非营养不良的SGA；营养不良的33例AGA相应的值也显著低于35例非营养不良的AGA。结论：IGF－1、RBP和PA可作为营养评价的生化指标，其敏感性高，不受胎龄的日龄、体重的影响，便于临床诊断、疗效评价，是诊断新生儿营养不良时形态指标无法代替的。

The Clinical Significance of Biochemical Indexes for Nutritional Assessment in Neonates

Objective To investigate the biochemical indexes for nutritional assessment in the newborns. Methods Serum insulin-like grouth factor-1 (IGF-1) levels in neonates were measured with RIA, retinol-binding protein (RBP) and prealbumin (PA) were measured with enzyme-liked immunosorbent assay (ELISA). The tested groups consisted of 65 SGAs and AGAs (according to birth weight) with nutritionally normals and abnormals approximately equally numbered. Results The serum levels of IGF-1, RBP and PA in the 32 malnutritional SGAs were significantly lower than those in the 35 nutritionally normal SGAs. The serum levels of the above-mentioned three in the 33 malnutritional AGAs were also significantly lower than those in the 35 nutritionally normal AGAs. Conclusion IGF-1, RBP and PA could be used as biochemical indexes for nutritional assessment and would not be affected by the gestational age and birth weight. Biochemical measurements cannot be substitued by anthropometric measurements for the diagnosis of neonatal malnutrition.