早产儿骨密度及骨源性碱性磷酸酶结果分析

Analysis of bone mineral density and bone alkaline phosphatase in premature infants

目的分析早产儿骨密度及骨源性碱性磷酸酶(BALP)结果,旨在了解早产儿骨营养情况,为临床指导提供依据。方法选取2016-01-01-2018-08-31天津市滨海新区妇女儿童保健和计划生育服务中心规律随访的415例早产儿为研究对象,收集矫正月龄3、6和12个月时的BALP及超声骨密度数据,采用χ^(2)检验及秩和检验对结果进行统计分析。结果早产儿在矫正月龄3、6和12个月时BALP阳性率分别为34.7%、23.4%和16.0%。在矫正月龄<12个月骨密度Z值中位数均<0,组间比较差异有统计学意义,H=283.06,P<0.001。不同性别早产儿在各个矫正月龄BALP及骨密度水平比较,差异无统计学意义,均P>0.05。中高危组和低危组早产儿在矫正月龄3和6个月时BALP比较,差异有统计学意义,χ^(2)值分别为8.867和8.519,P值分别为0.003和0.004;在矫正月龄12个月时比较,差异无统计学意义,χ^(2)=3.698,P=0.054。高、中和低危早产儿在矫正月龄3和6个月时骨密度Z值比较,差异有统计学意义,H值分别为11.841和8.071,P值分别为0.003和0.018;在矫正月龄12个月时比较,差异无统计学意义,H=2.727,P=0.256。结论早产儿BALP阳性率在婴儿期随着矫正月龄的增加逐渐下降,骨密度Z值婴儿期大多处于较低水平,骨营养状态并不理想,尤其中、高危早产儿。矫正月龄<6个月的骨营养状态应引起重视,需加强早期监测及管理。

Objective To understand the bone nutritional status of preterm infants and better guide clinical practice,this paper analyzed the results of bone mineral density(BMD)and bone alkaline phosphatase(BALP)in preterm infants.Methods The data of bone alkaline phosphatase and ultrasound bone mineral density of 415 preterm infants at 3,6 and 12 months of age were collected from January 1,2016 to August 31,2018 in women and children’health center in new area of Binhai,Tianjin,and the results were analyzed by chi-square and rank sum test.Results The positive rate of BALP was 34.7%,23.4%and 16.0%respectively at 3、6、12 months of corrected age.Within 12 months of corrected age,the median value of Zvalue of BMD was less than 0 and the difference was statistically significant(H=283.06,P<0.001).There was no significant difference in BALP and BMD between different genders of preterm infants at different corrected months(P>0.05).There was significant difference in BALP between high-risk group and low-risk group at 3,6 months of corrected age(χ^(2)=8.867 and 8.519,P=0.003 and 0.004)and there was no significant difference at 12 months of corrected age(χ^(2)=3.698,P=0.054).There was significant difference in Z value of BMD between high-risk group,moderate risk group and low-risk group at 3 and 6 months of corrected age(H=11.841 and 8.071,P=0.003 and 0.018)and there was no significant difference at 12 months of corrected age(H=2.727,P=0.256).Conclusions The bone nutritional status of preterm infants in our region is not ideal,especially in moderate and high-risk preterm infants.Attention should be paid to the bone nutritional status within 6 months of corrected month age,and early monitoring and management should be strengthened.