不同静脉营养液输注方法对早产儿脂质过氧化状态的影响

The Study of Three Methods in Premature Infants using Parenteral Nutrition of Lipid Peroxidation

目的本研究通过以不同静脉营养比例输注脂肪乳剂,比较脂质过氧化程度,以探讨临床上早产儿脂肪乳剂的合理输注方法。方法选取南方医科大学附属新会人民医院新生儿重症监护病房收治的早产极低出生体质量儿60例,随机分为A组、B组、C组,各20例,A组:与氨基酸、葡萄糖混合输注,混合经由避光管输注,3种供能比例50%:15%:35%,B组:成分与A组输注成分相同,混合经由避光管输注。葡萄糖、氨基酸、脂肪乳供能的比例不做调整。C组:成分与A组输注成分相同,混合不经由避光管输注。葡萄糖、氨基酸、脂肪乳供能的比例不做调整。3组患儿均于静脉营养5d后取静脉血5mL,检测丙二醛、谷胱甘肽过氧化物酶GSH-Px、胱抑素C。各组数据用χ—±s表示,资料用t检验。结果 MDA浓度A组最低,C组最高,GSH-Px A组最多,C组最少,CysCA组最多,C组最少,与GSH-Px的结果一致。结论早产儿输注静脉营养过程中,选用一次性黑色避光输注管输注并使葡萄糖、氨基酸、脂肪乳供能的比例调整为尽量接近或达到50%:15%:35%时脂质过氧化程度最轻,且CysC对判断脂质过氧化程度与GSH-Px一致,值得临床应用。

Objective This study through different parenteral nutrition proportion infuse fat emulsion,and compare lipid peroxidation,to explore the clinical infusion of fat emulsion in a reasonable way from preterm infants.Methods Selection 60 very low birth weight premature infants cases in the neonatal intensive care unit who treated in the People＇s Hospital of Xinhui,Southern Medical University,Randomly divided into A,B,C group,each 20 cases,Group A： Mix with Amino acids,Glucose to infuse,infuse through the dark tube.Group B： The composition is the same with group A,infuse through the dark tube,don＇t adjust the proportion of glucose,amino acids,fat emulsion.Group C： The composition is the same with group A,infuse through the dark tube,don＇t adjust the proportion of glucose,amino acids,fat emulsion.Take 5ml venous blood from the three groups after infused parenteral nutrition 5 days.Detect the malondialdehyde,glutathione peroxidase GSH-Px,cystatin C.In each group of data with χ±s and data with the t test.Results A group is the lowest MDA concentration,C group is the highest;GSH-Px,A group is the most,C group is the least;CysC,A group is the most,C group is the least;the results are consist with GSH-Px.Conclusion during the infusion of parenteral nutrition in premature infants,use a one-time infusion dark tube,and adjusted glucose,amino acids,fat emulsion for the ratio up to or as close as possible 50%： 15%： 35%,and then the lightest level of lipid peroxidation.CysC right to determine the degree of lipid peroxidation and GSH-Px in line,it is worth clinical application.