极低出生体重儿血清铁蛋白水平及影响因素

Serum ferritin in very low birth weight infants and its influence factors

目的分析极低出生体重儿（very low birth weight infants，VLBWI）的铁营养状况及影响其变化的因素。方法收集2014年1月至12月我院收治的115例VLBWI，检测其基础血清铁蛋白及出院前末次血清铁蛋白水平，并对可能的影响因素如胎龄、出生体重、基础血红蛋白、住院期间累积输血量、累积失血量，孕母糖尿病、高血压及贫血等临床资料进行分析。结果115例VLBWI的基础血清铁蛋白为100．8～210．3μg/L，平均（140．32±13．21）μg/L；不同胎龄的VLBWI基础血清铁蛋白水平比较差异有统计学意义（F=14．367，P=0．000），胎龄〈32周的VLBWI其基础血清铁蛋白最低[（124．5±31．3）g／L]。母亲贫血程度越重，婴儿基础血清铁蛋白越低[无贫血：（230．9±68．7）μg/L，轻度贫血：（189．5±75．3）μg/L，中度贫血：（133．5±88．1）μg/L，重度贫血：（122．24-56．8）μg/L；P〈0．05]。VLBWI基础血红蛋白水平越低，其基础血清铁蛋白水平越低（P〈0．05）。同时VLBWI住院期间末次血清铁蛋白水平受累积输血量的影响差异有统计学意义（P〈0．05）。结论提高VLBWI基础血红蛋白水平对增加VLBWI体内铁储备是有益的，定期监测住院期间甚至出院后血清铁蛋白以指导VLBWI补铁治疗十分必要。

Objective To identify iron nutritional status in very low birth weight infants （VLBWI） and its influence factors. Methods A total of 115 babies admitted from January to December 2014 were in- cluded in the study. Serum ferritin of new born infants was analyzed. The clinical data of gestational age ,birth weight,hemoglobin, iatrogenic blood loss, cumulative volume of blood transfusion and pregnancy maternal diseases（diabetes, hypertension and anemia） were analyzed. Results The serum ferritin of 115 VLBWI were 100. 8 to 210. 3 txg/L,the average were（ 140. 32 _± 13.21 ） p^g/L; the minimum serum ferritin of babies born 〈32 weeks gestational age were（ 124. 5 ±31.3） the basic baby serum ferritin （ F = 14. 367, P = 0. 000）μg/L. Smaller the VLBWI gestational age, the lower More severe the maternal anemia, the lower the basic baby serum ferritin levels E no anemia： （230. 9± 68.7 ） μg/L, mild anemia： （ 189.5 ± 75.3 ） μg//L, moderate anemia：（ 133.5 ± 88.1 ） μg//L, severe anemia：（ 122.2± 56. 8）μg/L;P 〈 0. 051± Lower the level of hemo- globin, the lower the basic level of serum ferritin（ P 〈 0. 05 ）. Volume of blood transfusion had a huge impact on the last serum ferritin levels （ P 〈 0. 05 ）. Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves. It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.