早期输注不同剂量氨基酸对早产儿血清前白蛋白的影响

Effect of early infusion of different doses of amino acids on serum prealbumin of premature infants

目的:评价早期输注不同剂量氨基酸对早产儿血清前白蛋白的影响。方法:将2010年4月～2011年3月收治接受静脉营养的早产儿90例(胎龄≤32周,体重≤2 000 g)随机分成3组各30例,大剂量组于生后24 h内给予2.0 g·kg-1.d-1的氨基酸,每日递增1.0 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1;中剂量组于生后24 h内给予1.0 g·kg-1.d-1的氨基酸,每日递增0.5 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1;小剂量组生后24 h内给予0.5 g·kg-1.d-1的氨基酸,每日递增0.5 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1。结果:各组出生第1天血清前白蛋白含量比较差异无统计学意义(P>0.05),但第7天血清前白蛋白浓度大剂量组与中剂量、小剂量组比较差异有统计学意义(P<0.05),中剂量组与小剂量组比较差异无统计学意义(P>0.05);第14天各组血清前白蛋白浓度比较差异有统计学意义(P<0.05)。结论:早期应用大剂量氨基酸可以提高血清前白蛋白浓度,从而改善早产儿的营养状况,促进生长发育。

Objective：To evaluate the effect of early infusion of different doses of amino acids on serum prealbumin of premature infants.Methods：Ninety premature infants（fetal age≤32 weeks,birth weight≤2 000 g） who received parenteral nutrition in the hospital from April 2010 to March 2011 were randomly divided into three groups,30 infants in each group.The infants in large dose group were treated with amino acids（2.0 g·kg^-1·d^-1） within 24 hours after birth,increasing by 1.0 g·kg^-1·d^-1 per day,the maximal dose was 3.5 g·kg^-1·d^-1;the infants in medium dose group were treated with amino acids（1.0 g·kg^-1·d^-1） within 24 hours after birth,increasing by 0.5 g·kg^-1·d^-1 per day,the maximal dose was 3.5 g·kg^-1·d^-1;the infants in small dose group were treated with amino acids（0.5 g·kg^-1·d^-1） within 24 hours after birth,increasing by 0.5 g·kg^-1·d^-1 per day,the maximal dose was 3.5 g·kg^-1·d^-1.Results：There was no significant difference in the serum prealbumin content on the first day after birth among the three groups（P〈0.05）,but on the seventh day after birth,there was significant difference in the serum prealbumin content between large dose group and medium dose group,small dose group（P〈0.05）,there was no significant difference between medium dose group and small dose group（P〈0.05）;on the fourteenth day after birth,there was significant difference in the serum prealbumin content among the three groups（P〈0.05）.Conclusion：Early application of large dose of amino acids can increase serum prealbumin content,improve nutritional status of premature infants,and promote the growth and development of premature infants.