早期高剂量氨基酸在早产儿静脉营养应用中的临床研究

Clinic study of early different doses of amino acid supplementation in preterm infants

目的评价早期高剂量氨基酸在早产儿静脉营养中的应用价值。方法将2008年1月～2010年12月我科收治的接受静脉营养的早产儿95例随机分成3组,高剂量组于生后24h内给予3g/(kg.d),每日递增0.5g/(kg.d),预期峰值为3.5g/(kg.d),中剂量组于生后24h内给予2g/(kg.d),每日递增0.5g/(kg.d),预期峰值为3.5g/(kg.d),低剂量组于生后24h内给予1g/(kg.d),每日递增0.5g/(kg.d),预期峰值为3g/(kg.d)。比较3组患儿的体重下降百分比、体重恢复时间、住院时间、血尿素值、血氨值、三酰甘油值及生后28d内发生动脉导管未闭的发生率。结果 3组资料比较,高剂量组的体重下降百分比、体重恢复时间及住院时间均明显减少,3组各项血清学指标及生后28d内发生动脉导管未闭的发生率差异无统计学意义。结论早期高剂量氨基酸在早产儿静脉营养中的应用,是安全和有效的。

Objective To assess the effectiveness and safety of early different doses of amino acid supplementation in preterm infants.Methods Totally 95 preterm infants were randomly divided into three groups.The high dose group（H group） were given amino acid supplementation 3g/（kg·d） originally,with 0.5g/（kg·d）increase every day till 3.5g/（kg·d）.The mild dose group（M group） were given amino acid supplementation 2g/（kg·d） originally,with 0.5g/（kg·d）increase every day till 3.5g/（kg·d）.The low dose group（L group） were given amino acid supplementation 1g/（kg·d） originally,with 0.5g/（kg·d）increase every day till 3g/（kg·d）.To compare the days of body loss,weight recovery,the hospital stays and the level of blood urea nitrogen,bloodammonia and triglyceride among the three groups.The incidence of patent ductus arteriosus（PDA） was also compared.Results The high dose group had a superiority in aspects of time of body loss,weight recovery and the hospital stays.Three was no significant difference statistically in the level of blood urea nitrogen,bloodammonia,triglyceride and the incidence of PDA.Conclusion Early high dose of amino acid supplementation in preterm infants in 24h after birth was safe and effective.