东莞地区早产儿氨基酸代谢水平的分析

Analysis of Amino Acid Metabolism Level of Premature Infants in Dongguan Area

目的:运用串联质谱技术分析东莞地区早产儿氨基酸代谢水平的变化特点。方法:选取2019年1-12月于东莞市出生的3381例早产儿(早产儿组)和3845例正常足月儿(正常足月儿组),并将早产儿组按不同出生体质量分为极低出生体重儿、低出生体重儿和单纯早产儿。采用串联质谱技术检测滤纸干血斑中9种氨基酸的浓度。比较早产儿与正常足月儿的氨基酸代谢水平的差异,分析三组不同出生体质量早产儿氨基酸代谢水平的变化特点。结果:早产儿组丙氨酸(Ala)、甘氨酸(Gly)、脯氨酸(Pro)、缬氨酸(Val)浓度均明显低于正常足月儿组,而瓜氨酸(Cit)、甲硫氨酸(Met)、苯丙氨酸(Phe)、酪氨酸(Tyr)浓度均明显高于正常足月儿组(P<0.05)。早产儿组中不同出生体质量早产儿9种氨基酸代谢水平比较,差异均有统计学意义(P<0.05)。其中Ala、Gly、Tyr浓度随着出生体质量的增加而升高,Cit、Phe浓度随着出生体质量的增加而降低。采用百分位数法,选择双侧限值的可信区间(P_(2.5)~P_(97.5))建立早产儿的氨基酸参考范围。结论:早产儿氨基酸代谢水平与正常足月儿存在明显差异,早产儿不同出生体质量可影响其体内氨基酸代谢浓度的分布。建议新生儿筛查实验室根据不同出生体质量建立早产儿氨基酸的参考范围,同时为临床早产儿合理的营养补充提供参考依据。

Objective:To analyze the changes in amino acid metabolism of preterm infants in Dongguan by tandem mass spectrometry.Method:A total of 3381 preterm infants(preterm infants group)and 3845 normal term infants(normal term infants group)who born in Dongguan City from January to December 2019 were selected,the preterm infants group was divided into very low birth weight infant,low birth weight infant and simple premature infant according to different birth weights.The concentration of 9 amino acids in dried blood spots on filter paper was detected by tandem mass spectrometry.The amino acid differences between preterm infants group and normal term infants group were compared,and the amino acid metabolism characteristics of three groups of preterm infants with different birth weights were analyzed.Result:The concentrations of alanine(Ala),glycine(Gly),proline(Pro)and valine(Val)in preterm infants group were significantly lower than those in normal term infants group,while the concentrations of citrulline(Cit),methionine(Met),phenylalanine(Phe)and tyrosine(Tyr)were significantly higher than those in normal term infants group(P<0.05).The comparison of 9 amino acid metabolism levels of preterm infants with different birth weights in preterm infants group were statistically significant(P<0.05).Among them,the concentrations of Ala,Gly,and Tyr increased with the increase of birth weight,while the concentrations of Cit and Phe decreased with the increase of birth weight.The percentile method was used to select confidence interval(P_(2.5)~P_(97.5))of the two-sided limit to establish the amino acid reference range for preterm infants.Conclusion:The amino acid metabolism level of preterm infants is significantly different from that of normal term infants,different birth weights of preterm infants can affect the amino acid metabolism concentration in their bodies.It is recommended that newborn screening laboratories establish a reference range for preterm infants based on different birth weights,and provide a reference for reasonable nutritional supplementation for clinical preterm infants.