早产儿早期血脂代谢特点及与新生儿呼吸窘迫综合征关系探讨

Relationship between early serum lipid profiles and respiratory distress syndrome in preterm infants

目的了解早产儿早期血脂代谢特点及其与新生儿呼吸窘迫综合征(RDS)的关系。方法将100例适于胎龄早产儿按胎龄或出生体重分组,并以40例足月适于胎龄儿作为对照组,于出生后12 h内静脉采血,测定血浆总胆固醇(TC)、甘油三脂(TG),低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平;另外,分别根据胎龄及出生体重进一步比较发生RDS与未发生RDS早产儿的血脂水平。结果随胎龄及体重增加,TG水平呈递增趋势,28-30周组及31-33周组早产儿血浆TG水平均明显低于34-36周早产儿及足月儿(P<0.01);出生体重≤1499 g组及1500-2499 g组早产儿血浆TG水平均明显低于出生体重≥2500 g早产儿及足月儿(P<0.05),且出生体重≤1499 g组与1500-2499 g组早产儿之间TG水平差异亦有统计学意义(P<0.01);而各组新生儿HDL-C、LDL-C及TC水平差异无统计学意义。RDS与非RDS早产儿血浆TC、LDL-C及HDL-C水平差异亦无统计学意义;但在胎龄28-30周组,RDS早产儿的TG水平比非RDS早产儿明显降低(P<0.05);体重≤1499 g RDS早产儿TG水平低于非RDS早产儿(P<0.05)。结论早产儿血脂水平与胎龄及体重相关,低TG水平可能是胎龄28-30周及体重≤1499 g早产儿出现RDS的原因之一。

Objective To investigate early serum lipid profiles in preterm infants and their relationship with neonatal respiratory distress syndrome （RDS）. Methods Appropriate-for-gestational-age （AGA） preterm infants were grouped according to gestational age （GA） or birth weight （BW）. AGA full-term infants were randomly selected as the control group. Venous blood samples were collected within 12 hours after birth for measurement of biochemical indices, including total cholesterol （TC）, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C） and triglyceride （TG）. Blood lipid levels were compared between preterm infants with and without RDS in various groups. Results Plasma TG level rose as GA and BW increased. Plasma TG levels in the 28-30 week and 31-33 week GA groups were significantly lower than in the 34-36 week GA and control groups （P〈0.01）. Plasma TG levels in the ≤1499 g and 1500-2499 g BW groups were significantly lower than in the ≥ 2500 g BW and control groups （P〈0.05）, and the 1500-2499 g BW group had a significantly higher plasma TG level than the ≤1499 g BW group （P〈0.01）. There were no significant differences in plasma HDL-C, LDL-C and TC levels between all groups and between preterm infants with RDS and without RDS. In the 28-30 week GA group, the preterm infants with RDS had a significantly lower TG level than those without RDS （P〈0.05）; also, in the ≤ 1499 g BW group, preterm infants with RDS had a significantly lower TG level than those without RDS （P〈0.05）. Conclusions Blood lipid levels are related to GA and BW. Low TG level may be one of the causes of RDS in preterm infants with a gestational age of 28-30 weeks and a BW of ≤ 1499 g.