摘要
目的探讨定量超声(QUS)技术评价早产儿骨发育的作用及早产儿骨发育的影响因素。方法选取2009年2～7月本院NICU住院的早产儿为观察组,按2∶1比例随机选择同期出生的足月儿为对照组,用定量超声仪测量生后2d之内胫骨声波速度(SOS),同时检测出生24h内血钙、镁、磷和碱性磷酸酶,分析不同胎龄、体重、性别、母妊娠期高血压疾病及生化指标等因素对SOS值的影响,对有意义的因素进行多元回归分析。结果(1)胫骨SOS值早产儿低于足月儿;胎龄≤30周早产儿低于胎龄34～36周早产儿和足月儿,胎龄31～33周早产儿低于胎龄34～36周早产儿和足月儿;出生体重<1500g新生儿低于1500～2500g和>2500g的新生儿,P均<0.05;不同性别之间SOS值差异无统计学意义(P>0.05);早产适于胎龄儿低于早产小于胎龄儿,P<0.001;母妊娠期高血压疾病组早产儿高于非妊娠期高血压疾病组,P<0.05。(2)SOS值与胎龄(r=0.347,P<0.001)、母妊娠期高血压疾病(r=0.215,P=0.016)、宫内发育迟缓(r=0.367,P<0.001)、血钙(r=0.259,P=0.004)和血镁(r=0.234,P=0.008)正相关,与血磷(r=-0.201,P=0.025)负相关;多元回归分析发现胎龄、宫内发育迟缓和镁是影响SOS的重要因素(P<0.001)。结论QUS可以准确的评价胎儿骨营养状态,胎龄、宫内生长迟缓和镁是胎儿骨发育的重要影响因素。
Objective To study the role of Quantitative ultrasound （Qus） which evaluate the skeletal development of preterm infants and the influence factors of bone development in prematurity. Methods We selected the preterm infants who hospitalized in the NICU from February 2009 to July 2009 as the observation group according to a ratio of 2：1 randomly selected the full-term children born in the same period as the control group. We used ultrasound bone sonometer to measure the SOS value along the mid tibia in two groups of neonates born after 2 days after birth, simultaneously we measured the serum calcium, magnesium, phosphorus and alkaline phosphatase concentrations in neonates born within 24 hous after birth. We analysed the impact of gestational age, weight, gender, mother of pregnancy- induced hypertension and other factors such as biochemical indicators on the value of SOS, those significant factors were put into multiple regression analysis. Results （ 1 ） The SOS values of premature infants [ （2992 ± 124） m/s] were lower than that in full-term infant [ （3047 ± 145） m/s]. SOS values in≤ 30 weeks gestational age group [ （2922 ± 164） m/s] were lower than that of 34 to 36 weeks group [（3018 ± 113） m/s] and the full term group, SOS values of 31 -33 weeks gestational age group [ （2961 ± 125） m/s] were lower than that of 34 to 36 weeks gestational age group and the full-term group. The tibia SOS value of birth weight infants less than 1500 g [ （2930 ± 136） m/s] were significantly lower than that of 1500 -2500 g birth weight babies [ （3006 ± 125 ） m/s] and that of infant birth weight greater than 2500 g [ （3039 ± 142） m/s] ,P values were all less than 0. 05. No significant difference in SOS value was found between the male and female infants （ P 〉 0.05 ）. SOS values in preterm infants of appropriate for gestational age [ （2965±122 ） m/s ] group were lower than that of small for gestational age of premature infants [ （3055 ± 105） m/s,P 〈0. 001 ]. SOS values [ （3028 ±126） m/s] were higher in premature infants with mothers of pregnancy-induced hypertension than that of non-pregnancy-induced hypertension [ （2971 ± 118） m/s, P 〈 0. 05 ]. （2） The SOS value of the premature infants had positive correlation with GA （r =0. 347 ,P 〈0. 001 ） ,mother of pregnancy-induced hypertension （r = 0. 215, P = 0. 016）, intrauterine growth retardation （ r = 0. 367, P 〈 0. 001 ）, calcium （r = 0. 259,P = 0. 004） and magnesium （ r = 0. 234, P = 0. 008 ） , negative correlation with phosphorus （r = -0. 201, P =0. 025）. Multiple regression analysis showed that GA,intrauterine growth retardation and magnesium were three important factors which may contribute to bone SOS of neonates （ F = 11. 639, P 〈 0. 001 ）. Conclusion QUS is a quite useful technique in evaluation bone status of fetus, especially in preterm infants. The correlated influence factors of bone status in fetus were GA, intrauterine growth retardation and magnesium.
出处
《中国新生儿科杂志》
CAS
2010年第3期146-149,共4页
Chinese Journal of Neonatology
关键词
骨密度
定量超声
婴儿
早产
宫内发育迟缓
Bone density
Quantitative ultrasound
Infant, premature
Intrauterine growth retardation
