极低出生体重儿早期营养状况对神经发育的影响

Influence of early nutritional status on neurologic development in very low birth weight infants

目的探讨新生儿重症监护病房极低出生体重儿早期营养状况对其后期神经发育的影响。方法 2013年1月-2014年6月在广州市妇女儿童医疗中心NICU住院的极低出生体重儿86例,出院后定期在本院高危儿门诊随访,根据其矫正年龄3个月发育评估测试所得发育商(DQ)分为神经发育正常组和神经发育异常组,对两组患儿住院期间的营养状况进行分析。结果神经发育正常组生后第4、7、14天总能量、肠内能量所占比例及第4、7天氨基酸供给量均高于神经发育异常组,差异具有统计学意义(P<0.05);神经发育正常组体重下降严重程度较神经发育异常组轻,恢复出生体重时间及达到全胃肠道喂养时间较神经发育异常组早,两组差异具有统计学意义(P<0.05)。结论极低出生体重儿早期良好的营养状况可明显改善其神经系统发育结局。

Objective To investigate the effects of early nutritional status of very low birth weight infants （VLBWI） in neonatal intensive care unit （NICU） on their neurologie development thereafter. Methods The study was conducted in NICU of Guangzhou Women and Children＇s Medical Center from January 2013 to June 2014. A total of 86 VLBWIs who met the entry criteria had been followed up in high-risk infant outpatient service after leaving hospital regularly, and they were assigned to two groups （normal neural development group and abnormal neurologic development group） according to their development quotients （DQ） examined through development test at 3 months corrected age, then their nutritional status were analyzed during hospitalization respectively. Results In normal neurologic development group,the gross energy and the proportion of enteral energy were higher compared with abnormal neurologic development group on 4 d, 7 d and 14 d after birth,and the supply of amino acids was also higher than that abnormal neurologic development group on 4 d and 7 d after birth, the statistical differences were significant （P〈0. 05） ;Compared with abnormal neurologic development group, the weight reduction of VLBWIs in normal neurologic development group was less and they could revert to birth weight and achieve full gastrointestinal feeding earlier,the difference between two groups had statistical significance （P〈0.05）. Conclusion Early better nutritional status of VLBWI can improve the effects of their neurologic development significantly.