早产儿出生第一天血清蛋白质水平影响因素探讨

Investigation of the factors affecting serum protein levels in premature infants on the first day of life

目的探讨早产儿出生第一天血清蛋白水平的影响因素。方法回顾性分析2007年12月至2011年12月的住院早产儿578例,男350例、女228例,孕周(32.44±2.48)周,出生体质量(1771.75±471.59)g。测定血清白蛋白(ALB),总蛋白(TP),前白蛋白(PA),球蛋白(GLB)。结果早产儿出生第一天的血清ALB、TP、PA、GLB测量值均呈正态分布。极低出生体重质量(VLBW)和低出生体质量(LBW)早产儿的血清ALB、GLB、TP水平均低于出生体质量>2 500 g的早产儿,差异有统计学意义(P<0.05)。不同出生体质量早产儿的PA水平差异无统计学意义(P>0.05)。随出生孕周增加,早产儿平均血清ALB、GLB、TP水平也逐步增加,差异有统计学意义(P<0.05)。小于胎龄儿(SGA)的PA水平低于适于胎龄(AGA)早产儿,差异有统计学意义(P<0.05)。结论随出生孕周和出生体质量增加,早产儿平均血清ALB、TP、GLB水平逐步增加。PA可能反映了胎儿宫内营养状况。

Objective To study the factors affecting the serum protein levels in premature infants on the first day of life. Methods Five hundreds and seventy-eight premature infants （350 males and 228 females） were admitted to neonatal intensive care unit from December 2007 to December 2011. Mean gestational age was （32.44±2.48） weeks and mean birth weight was （1771.75±471.59） gram. Serum protein concentrations including albumin （ALB）, total protein （TP）, prealbumin （PA） and gob- lin （GLB） were measured. Results Serum ALB, TP, PA and GLB values in premature infants showed a normal distribution. The serum ALB, GLB and TP values were significantly lower in very low birth weight （VLBW） and low birth weight （LBW） premature infants than those in premature infants with birth weight 〉2 500 g （P〈0.05）. Serum ALB, GLB and TP values in VLBW premature infants were significantly lower than those in LBW premature infants （P〈0.05）. There was no significant difference of serum PA value among the three groups （P〉0.05）. With the increase in gestational age, the average serum ALB, GLB and TP levels were significantly increased （P〈0.05）. Serum PA value in small-for-gestational-age （SGA） premature in fants was significantly lower than that in adequate-for-gestational-age （AGA） premature infants （P〈0.05）. Conclusions With the increase in gestational age and weight gain, the mean serum ALB, TP, and GLB concentrations are gradually increased in premature infants. On the first day of life, serum PA concentration in SGA premature infants is significantly lower than that in AGA premature infants. It suggests serum PA concentration may reflect the nutritional status of the fetus in uterus.