摘要
目的评价早期输注大剂量氨基酸对改善早产儿氮平衡的有效性。方法将2010年1月—2010年12月间出生24 h内体质量1 000～2 000 g入住新生儿重症监护室(NICU)接受肠道外营养治疗的早产儿,随机分为两组。实验组于生后24 h内输注氨基酸2.0 g/(kg.d)起,每天增加0.85 g/kg,预期峰值3.7 g/(kg.d);对照组于出生24 h内输注氨基酸0.5 g/(kg.d)起,每天增加0.5 g/kg,预期峰值3.7 g/(kg.d)。结果实验组早产儿生后第1周均处于正氮平衡;对照组早产儿生后前3 d均处于负氮平衡;实验组早产儿第1周每天平均氮平衡值均大于对照组,差异有统计学意义(P均<0.01)。实验组早产儿体质量下降百分比少于对照组,差异有统计学意义(P<0.05);头围增长大于对照组,差异有统计学意义(P<0.05);达到肠内营养418.4 kJ/kg的天数、恢复出生体质量的天数和体质量达到2 000 g的天数均少于对照组,差异有统计学意义(P均<0.05)。结论早产儿生后24 h内即开始输注大剂量氨基酸(2.0 g/kg)能显著改善氮平衡,增加喂养耐受性和促进早产儿生长。
Objective To evaluate the efficacy of parenteral nutrition with high-dose amino acids in improving nitrogen balance of premature infants.Methods Premature infants（birth weight 1 000 ～ 2 000 g）recruited into the study were randomized divided into two groups.Trials group（TP）：2.0 g/（kg·d）of amino acid IV within 24 hours after birth,increasing by increments of 0.85 g/（kg·d）to a maximum of 3.7 g/（kg·d）;Control group（CP）：0.5 g/（kg·d）of amino acid IV within 24 hours after birth,increasing by increments of 0.5 g/（kg·d）to a maximum of 3.7 g/（kg·d）.Results TP group showed positive nitrogen balance every day;CP group showed negative nitrogen balance during the first three days,mean nitrogen balance was significantly higher in TP group than in CP group（P 0.01）.TP group showed significantly less weight loss（P 0.05）,more head circumference gain,quicker growth,shorter day length to tolerate 418.4 kJ/（kg·d）enteral nutrition,shorter day length to regain birth weight and reach 2 000 g than in CP group（all P 0.05）.Conclusions Early administration of intravenous amino acids[2.0 g/（kg·d）]significantly improves nitrogen balance,growth and tolerance of enteral feeding in premature infants.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2012年第3期225-229,共5页
Journal of Clinical Pediatrics
基金
福建省卫生厅青年科研课题资助(No.2010-2-130)
福建省莆田市科技项目计划资助(No.2010 S 10-4)
关键词
氮平衡
早产儿
胃肠外营养
氨基酸
nitrogen balance
premature
parenteral nutrition
amino acids
