早期血脂代谢指标对不同胎龄早产儿营养评估价值

The Value of Nutritional Assessment of the Early Lipids Metabolism Indicators to the Premature Infants of Different Gestational Ages

目的通过测定不同胎龄、不同相对体质量早产儿早期血脂生化指标,探讨早产儿早期血脂代谢指标对指导早产儿营养支持治疗及预防疾病的临床意义。方法选取2012年9月—2014年4月同期住院的新生儿189例,分为≤28周组16例、28-32周组53例、32-37周组72例、足月儿组48例。于出生后24 h内采集静脉血2 mL,测定总胆固醇及甘油三酯。结果4个胎龄组间比较,总胆固醇水平以28-32周组最高,足月儿组胆固醇代谢水平最低,差异有统计学意义（P〈0.05）。4个胎龄组间比较,甘油三酯水平以28-32周组最低,早产儿甘油三酯水平低于足月儿,差异有统计学意义（P〈0.05）。28-32周组内AGA较SGA、LGA总胆固醇水平高,差异有统计学意义（P〈0.05）,余三个胎龄组内SGA、AGA及LGA间总胆固醇差异无统计学意义（P〉0.05）。各胎龄组内SGA、AGA及LGA间甘油三酯水平差异无统计学意义（P〉0.05）。结论早产儿胆固醇代谢水平高于足月儿,早产儿甘油三酯水平低于足月儿。监测早产儿血脂水平变化,对临床合理营养支持治疗及预防疾病具有指导意义。

Objective To probe the clinical significance of early indicators of lipid metabolism in guiding the nutritional support and prevention of disease for premature infants at different gestational ages with different relative body weight through measuring their early blood biochemical indexes. Methods 189 newborns hospitalized from September 2012 to April 2014 were selected and divided into four groups, namely, 16 infants with the gestational age of no more than 28 weeks, 53 infants from 28 weeks to 32 weeks, 72 infants from 32 weeks to 37 weeks and 48 full-term infants. 2 ml of venous blood of the infants was collected within 24 hours after the born of these infants for measuring the total cholesterol and triglyceride. Results Comparing among the four groups,the group of infants with the gestational age from 28 weeks to 32 weeks have the highest level of total cholesterol, the full-term babies have the lowest level of cholesterol metabolism, the difference has a statistical significance（P〈0.05）. The group of infants with the gestational age from 28-32 weeks have the lowest level of triglyceride, the triglyceride level of full-term babies is higher than that of the premature infants, which has statistically significant difference（P〈0.05）. Within the group with the gestational age of 28-32 weeks, compared to SGA, LGA, AGA has higher level of total cholesterol, the differences have a statistical significance（P〈0.05）. For the other three groups, SGA, AGA and LGA have no statistically significant differences in the level of total cholesterol（P〉0.05）. Within individual gestational age group, SGA, AGA and LGA have no statistically significant differences in the level of triglyceride（P〉0.05）. Conclusion Premature infants have a higher level of cholesterol metabolism than full-term babies.Full-term babies have lower level of triglyceride than premature infants. Monitoring the change of blood lipid level for premature infants is of guiding significance in clinical nutritional support and prevention of diseases.