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目的观察NICU中不同胎龄低出生体质量儿血生化指标,探讨临床早期评估低出生体质量儿营养状况的敏感指标。方法采用前瞻性研究方法观察不同胎龄低出生体质量儿[胎龄28～31周(G 28-31)组、胎龄32～36周(G 32-36)组和胎龄37～42周(G 37-42)组]在新生儿期第1天和肠内营养达到推荐摄入标准(RDIs)后第1天血清清蛋白(ALB)、血糖(Glu)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)水平变化。结果在新生儿期第1天,胎龄越小,血ALB水平越低,3组ALB水平比较差异有统计学意义(P<0.05)。G 37-42组在新生儿期第1天TC、LDL-C、ApoB明显低于G28-31组和G32-36组,而在肠内营养达到RDIs后第1天,其TG、LDL-C、ApoB上升趋势明显高于G28-31组和G32-36组,差异均有统计学意义。结论血ALB是临床早期评估不同胎龄低出生体质量儿营养状况的敏感指标之一,定期监测血脂中LDL-C、ApoB水平变化,可为新生儿早期营养干预提供合理指导,避免在追赶式生长过程中不适当地补充营养,导致代谢紊乱,产生远期不良后果。
Objective To observe the biochemical markers of children with different gestational age and low birth weight in the NICU, and to explore the sensitive indexes for evaluating the nutrition status of low birth weight children in early stage of NICU. Methods A prospective study was conducted to observe the effects of different gestational age and gestational age on gestational age [gestational age at 28-31 weeks (G 28-31), gestational age 32-36 weeks (G 32-36) and gestational age 37-42 weeks (G 37-42) group] on day 1 of neonatal period and enteral nutrition after reaching the recommended intake criteria (RDIs) on day 1 of serum albumin (ALB), blood glucose (Glu), total cholesterol (TC) (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA) and apolipoprotein B (ApoB) Results On the first day of neonatal period, the gestational age was smaller and the level of blood ALB was lower. There was significant difference in ALB level between the three groups (P <0.05). The levels of TC, LDL-C and ApoB in G 37-42 group were significantly lower than those in G28-31 group and G32-36 group on the first day of neonatal period. On the 1st day after enteral nutrition reached RDIs, TG, LDL-C , The upward trend of ApoB was significantly higher than G28-31 group and G32-36 group, the differences were statistically significant. Conclusion Blood ALB is one of the sensitive indicators to assess the nutritional status of low birth weight infants with different gestational age in early clinical stage. Regular monitoring of LDL-C and ApoB levels in blood lipids may provide reasonable guidance for early neonatal nutrition intervention, Inappropriate growth during the nutritional supplements, leading to metabolic disorders, resulting in long-term adverse consequences.