早产儿静脉营养中不同初始剂量氨基酸供给方案研究

The study on early different doses of amino acid supplementation in preterm infants

目的评价早期应用不同初始剂量氨基酸对早产儿生长发育的影响。方法 62例早产低出生体质量儿根据氨基酸的不同起始剂量随机分为低剂量组、中剂量组和高剂量组。测量其体质量、身长、枕额头围、上臂围等生长指标变化,监测血尿素氮、肌酐、胆红素、血气分析等血生化指标。结果 (1)各生长指标比较,差异无统计学意义(P>0.05);(2)恢复出生体质量、静脉营养使用和住院时间比较,差异无统计学意义(P>0.05);(3)出生后7日血尿素氮水平比较,差异有统计学意义(P<0.05);血尿素氮水平异常发生率比较,差异无统计学意义(P>0.05);血肌酐水平比较,差异无统计学意义(P>0.05);(4)pH值、直接胆红素水平比较,差异无统计学意义(P>0.05)。结论早期高剂量氨基酸摄入有利于早产儿早期达到正氮平衡,并且不会增加代谢性酸中毒、肾功能损害、胆汁郁积症等不良后果的发生。

Objective To assess the effectiveness of early different doses of amino acid supplementation in preterm infants. Methods We randomly allocated sixty-two approaches to intravenous amino acid administration which were divided into low dose, median dose, high dose groups. We compared the weight, length, head circumference, upper arm circumference among the three groups,and detected the level of blood urea nitrogen, creatinine, bilirubin and the results of the blood gas analysis. Results （1） There were no significant difference among the three groups in the weight, length, head circumference and upper arm circumference （P^0.05） ^（2） There were no significant difference among the three groups in the time of rebounding to birth weight,the time of needing intravenous nutrition and the time of hospitalizing（P〉0.05）. （3） The blood urea nitrogen level of the patients in the low dose group was less than in the median dose group or high dose group（P〈0.05） ,There were no significant difference among the three groups in the level of ereatinine（P〉0.05） ; （4） There were no significant difference＇among the three groups in the level of bilirubin and the results of the blood gas analysis（P〉0.05）. Conclusion Early higher doses of amino acid supplementation were associated with increased blood urea nitrogen levels and a earlier positive nitrogen balance, and not resulted in increased incidence of metabolic acidosis,renal dysfunction or cholestasis.