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目的探讨瘦素质量浓度与早期静脉营养及生长发育的关系。方法新疆医科大学第一附属医院新生儿科于2005-01—2006-02,将收治的86例早产适于胎龄儿用随机数字表法分为观察组(早期微量喂养同时辅助胃肠外营养组)45例和对照组(单纯早期微量喂养组)47例,分别测定脐血及第7天血清瘦素质量浓度,同时监测营养状况和生长发育指标,并作对比分析。结果(1)观察组与对照组脐血瘦素质量浓度分别为(4.6±3.7)ng/mL、(4.8±2.2)ng/mL,生后第7天两组瘦素质量浓度分别为(4.3±2.2)ng/mL、(3.1±1.7)ng/mL。对照组第7天血清瘦素质量浓度明显低于脐血(P<0.05),而观察组其差异无统计学意义(P>0.05)。(2)脐血瘦素质量浓度与出生体重、胎龄成正相关(r=0.56、r=0.67)。(3)观察组第7天热卡及蛋白质摄入量、血清瘦素质量浓度、皮褶厚度变化值与对照组相比,差异有统计学意义(P<0.05)。结论对早产儿应尽早喂养,同时需要胃肠外营养作为肠内营养的补充。瘦素可作为新生儿营养效果判定的实验室指标之一。
Objective To investigate the relationship between leptin concentration and early venous nutrition and growth and development. Methods The neonatology department of the First Affiliated Hospital of Xinjiang Medical University from January 2005 to February 2006, 86 preterm infants who were born for gestational age were randomly divided into observation group (early micronutrient group and auxiliary parenteral nutrition group ) 45 cases and control group (simple early micronutrient group) 47 cases, cord blood and serum leptin concentrations were measured on the 7th day, meanwhile nutritional status and growth and development indicators were monitored and compared. Results (1) The leptin concentrations in the observation group and the control group were (4.6 ± 3.7) ng / mL and (4.8 ± 2.2) ng / mL respectively, and the leptin concentrations in the two groups were (4.3 ± 2.2) ng / mL, (3.1 ± 1.7) ng / mL. The serum leptin concentration of the 7th day in the control group was significantly lower than that in cord blood (P <0.05), but there was no significant difference in the observation group (P> 0.05). (2) Cord blood leptin concentration was positively correlated with birth weight and gestational age (r = 0.56, r = 0.67). (3) The changes of caloric intake and protein intake, serum leptin concentration and skinfold thickness in the observation group on day 7 were significantly different from those in the control group (P <0.05). Conclusion Premature infants should be fed as soon as possible, and parenteral nutrition as a supplement to enteral nutrition. Leptin can be used as one of the laboratory indicators to determine the effect of neonatal nutrition.