CAJ | 학술논문

目的研究早期应用小儿氨基酸对早产小于胎龄儿宫外生长发育的影响.方法选取2011年6月至2013年5月本院新生儿重症监护室(NICU)住院的106例早产小于胎龄儿为研究对象,将患儿按随机数字表法分为2组:治疗组(53例,T组)和对照组(53例,C组)；再将T组和C组按胎龄和出生体重分为4个亚组[≥34周组(T1组,C1组),＜34周组(T2组,C2组)；＜1.5 kg组(T3组,C3组),≥1.5 kg组(T4组,C4组)],观察生后6h和生后12 h应用小儿氨基酸对患儿宫外生长的影响,以及相关生化指标的影响.结果治疗2周后,T组患儿头围和体重增长值高于C组(P ＜0.05或P＜0.01),恢复出生体重时间明显缩短(P＜0.05或P＜0.01)；T组宫外发育迟缓(EUGR)发生率低于C组(P＜0.01),T组血尿素氮(BUN)显著高于C组(P＜0.01),两组血ALT、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、胆固醇(CH)和甘油三酯(TG)水平比较差异均无统计学意义(P＞0.05).C组中C4与T4的丙氨酸氨基转移酶(ALT)比较差异有统计学意义(P＜0.01).不同出生体重组中,治疗2周后,T组患儿血BUN水平高于C组(P＜0.05),但两组血AST、TBIL、CH、TG水平比较差异均无统计学意义(P＞0.05)；C4组EUGR发生率高于T4组(P＜0.05).结论早产小于胎龄儿生后6h开始应用小儿氨基酸(1 g/kg),是安全的,可促进头围和体重的增长、缩短出生体重恢复时间和降低宫外生长发育迟缓发生率.
목적 연구조기응용소인안기산대조산소우태령인궁외생장발육적영향.방법 선취2011년6월지2013년5월본원신생인중증감호실(NICU)주원적106례조산소우태령인위연구대상,장환인안수궤수자표법분위2조:치료조(53례,T조)화대조조(53례,C조)；재장T조화C조안태령화출생체중분위4개아조[≥34주조(T1조,C1조),＜34주조(T2조,C2조)；＜1.5 kg조(T3조,C3조),≥1.5 kg조(T4조,C4조)],관찰생후6h화생후12 h응용소인안기산대환인궁외생장적영향,이급상관생화지표적영향.결과 치료2주후,T조환인두위화체중증장치고우C조(P ＜0.05혹P＜0.01),회복출생체중시간명현축단(P＜0.05혹P＜0.01)；T조궁외발육지완(EUGR)발생솔저우C조(P＜0.01),T조혈뇨소담(BUN)현저고우C조(P＜0.01),량조혈ALT、천문동안산안기전이매(AST)、총담홍소(TBIL)、담고순(CH)화감유삼지(TG)수평비교차이균무통계학의의(P＞0.05).C조중C4여T4적병안산안기전이매(ALT)비교차이유통계학의의(P＜0.01).불동출생체중조중,치료2주후,T조환인혈BUN수평고우C조(P＜0.05),단량조혈AST、TBIL、CH、TG수평비교차이균무통계학의의(P＞0.05)；C4조EUGR발생솔고우T4조(P＜0.05).결론 조산소우태령인생후6h개시응용소인안기산(1 g/kg),시안전적,가촉진두위화체중적증장、축단출생체중회복시간화강저궁외생장발육지완발생솔.
Objective To explore the effect of early application of pediauic amino acids on extrauterine growth and development of preterm and small for gestational age infants.Methods A total of 106preterm and small for gestational age infants was selected in our NICU from June 2011 to May 2013,and randomly divided into two groups:treatment group (group T) and control group (group C).Next,each group was divided into two subgroups according to gestational age and birth weight.Such as ≥34W group (group T1,group C1),＜ 34W group (group T2,group C2),＜ 1.5 kg group (group T3,group C3) and ≥ 1.5 kg group (group T4,group C4).They were observed the effect of extrauterine growth and correlative serum biochemical indicators with application of pediatric amino acid in postnatal 6 hours and 12 hours.Resuits After 2-week treatment,the head circumference and weight growth of group T were higher than that of group C (P ＜ 0.05,or P ＜ 0.01),and the time of birth weight recovery was significantly shortened(P ＜ 0.05,or P ＜ 0.01).The incidence rate of extrauterine growth retardation(EUGR) in the group T was lower than that in group C,there is significantly statistical differences(P ＜ 0.01).The concentration of blood urea nitrogen (BUN) in group T was obviously increased than that in the group C(P ＜0.01).The levels of ALT,aspartate aminotransferase (AST),total bilirubin (TBIL),cholesterol (CH) and triglycerides (TG) were not different between the group T and group C.The comparison of alanine aminotransferase (ALT) levels were statistically significant between group C4 and group T4.In the different gestational age groups,the concentration of BUN in group T was obviously higher than that in the group C after 2-week treatment(P ＜0.05),the levels of AST,TBIL,CH and TG were not different between the group T and group C (P ＞ 0.05).The incidence rate of EUGR in the 4th group C was increased significantly than that in the 4th group T(P ＜0.05).Conclusions The preterm and small for gestational age infants were safe after the pediatric amino acid was used at the 6 h after birth.Amino acid can promote growth of head circumference and weight,shorten the birth weight recovery time and reduce the incidence of EUGR.