新生儿营养评价生化指标参考区间的调查

Investigation of the reference interval of neonatal nutrition assessment biochemical factor

目的对新生儿营养评价指标血清总蛋白、白蛋白、前白蛋白及视黄醇结合蛋白的参考区间进行调查。方法收集2016年12月至2017年8月间湖南省儿童医院健康体检新生儿的血清标本403例,测定血清中总蛋白、白蛋白、前白蛋白及视黄醇结合蛋白的浓度;对各检测项目结果按性别、周龄进行分组比较后建立各项目的参考区间。结果健康新生儿各项目测定值男女间差异无统计学意义(P>0. 05);总蛋白、白蛋白、视黄醇结合蛋白在出生后各周龄间差异无统计学意义(P>0. 05), 1周龄的新生儿前白蛋白浓度与其他周龄的新生儿比较差异有统计学意义(P <0. 05)。健康新生儿血清总蛋白、白蛋白、视黄醇结合蛋白及前白蛋白的参考区间依次为:40. 69～65. 72 g/L、28. 77～42. 3 g/L、12. 13～33. 19 mg/L、42. 26～161. 52 mg/L(≤7 d)及59. 05～170. 23 mg/L(8～28d)。结论新生儿血清总蛋白、白蛋白、视黄醇结合蛋白建立参考区间时可不区分性别、周龄,而前白蛋白1周内新生儿的参考区间需要与其他周龄的新生儿区分。

Objective To investigate the reference interval of neonatal nutrition assessment bio- chemical factor, including total protein （TP） , serum albumin （ALB） , serum prealbumin （PA） and serum retinol binding protein （RBP）. Methods From December 2016 to August 2017, 403 serum specimens were collected from health neonates in Hunan Children~ Hospital and the serum concentration of TP, ALB, RBP and PA was detected. The results of each item were grouped according to sex and age, and then the reference interval of each item was established. Results When data was separated by gender of each item, there was no statistical significance between each group of each item （ P 〉 0. 05 ）. For the TP, ALB and RBP, separating the data of each item by weeks , there were also no statistical significance between each group （ P 〉 0. 05 ）. But there was statistical difference between one week old group and the rest groups in the data of PA （ P 〈 0. 05 ）. The normal reference interval of neonatal serum total protein, albumin, retinol binding protein and pre-albumin are as follow ： （ 40. 69 - 65.72 ） g/L, （ 28.77 - 42. 3 ） g/L, （ 12. 13 - 33.19）mg/L, （42.26 - 161.52）mg/L （no more than 7 days old） and （59.05 - 170.23）mg/L （range from 8 to 28 days old）. Conclusions We can establish the reference interval of TP, ALB and RBP without differentiating gender and weeks. But for the PA , the reference interval of one-week-old neonate needs to differentiate from other neonates.