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目的研究早产儿生后3天血游离肉碱水平与新生儿肺透明膜病疾病严重程度的相关性。方法选择我院新生儿重症监护室胎龄为28~32w、并诊断患有新生儿肺透明膜病的早产儿60例。根据《实用新生儿学(第4版)》,诊断为新生儿肺透明膜病Ⅰ~Ⅱ级者纳入轻症组(30例),诊断为新生儿肺透明膜病Ⅲ~Ⅳ级者纳入重症组(30例)。所有对象于生后3天采其足跟血,滴于专用滤纸片上,行串联质谱检测,测定其游离肉碱水平。结果两组早产儿在胎龄、性别、体重等方面差异无统计学意义(P>0.05),具有可比性。生后3天轻症组早产儿血游离肉碱水平为(20.95±5.67)μmol/L,重症组早产儿血游离肉碱水平为(17.87±4.32)μmol/L,两组相比,重症组早产儿血游离肉碱水平明显低于轻症组(t=2.37;P=0.02)。结论新生儿肺膜病早产儿病情越重,血游离肉碱水平越低,游离肉碱可能参与了新生儿肺透明膜病的发病机制,该类患儿可能需要更多的肉碱促进肺表面活性物质的生成。
Objective To investigate the correlation between serum carnitine levels and the severity of hyaline membrane disease in neonates 3 days after birth. Methods Select neonatal intensive care unit in our hospital gestational age of 28 ~ 32w, and diagnosed with neonatal hyaline membrane disease in 60 preterm children. According to “Practical Neonatology (4th Edition)”, diagnosed as neonatal hyaline membrane disease grade Ⅰ ~ Ⅱ were included in the mild group (30 cases), diagnosed as neonatal hyaline membrane disease Ⅲ ~ Ⅳ grade into severe Group (30 cases). All objects were collected 3 days after birth heel blood, dropped on a special filter paper, tandem mass spectrometry detection, determination of its free carnitine levels. Results There was no significant difference in gestational age, sex, body weight between two groups of preterm infants (P> 0.05). The level of free carnitine in preterm infants was (20.95 ± 5.67) μmol / L on the 3rd day after birth in the severe group and (17.87 ± 4.32) μmol / L on the preterm infants in the severe group. Compared with the severe group The level of free carnitine in preterm children was significantly lower than in the mild group (t = 2.37; P = 0.02). Conclusions Preterm infants with neonatal pulmonary disease, the heavier the disease, the lower the level of free carnitine, free carnitine may be involved in the pathogenesis of neonatal hyaline membrane disease, such children may need more carnitine to promote lung surface Active substance generation.