不同随访模式早产儿生后6至12月营养相关指标的对比研究

目的 监测规律随访与未规律随访模式早产儿生后6~12月间(矫正月龄)血清25-羟维生素D₃25-(OH)D₃]、钙(Ca)、磷(P)、碱性磷酸酶(ALP)、尿素(UREA)、前白蛋白(PA)的水平,探讨两种随访模式对早产儿营养状况的影响及其安全性。方法 回顾性分析2015年1月-2017年12月在陆军军医大学第二附属医院院门诊就诊的143例早产儿资料,其中定期规律随访者79例设为A组,另外因各种原因未能定期规律随访者64例设为B组,同时将同期在本院儿保门诊随访的足月健康婴儿253例设为C组。婴儿于出生第6月至第12月(早产儿为矫正月龄)间抽血查血清25-(OH)D₃、Ca、ALP、P、UREA、PA水平。结果 1)A组及C组的血清25-(OH)D₃、Ca、PA均显著高于B组(P<0.05)。A组的血清25-(OH)D₃高于C组,差异具有统计学意义(P<0.05)。A、B、C三组间血清ALP、P、UREA差异无统计学意义(P>0.05)。2)A、B、C三组25-(OH)D₃测值评价结果比较:三组均无中毒病例,评价为25-(OH)D₃值适宜的例数A组最多,B组最少。结论 1)定期规律随访并按儿保建议喂养的早产儿,其生后6至12月血清25-(OH)D₃缺乏及低前白蛋白血症发生率低。2)早产儿喂养方案需个体化。3)部分早产儿营养评价指标(如:ALP)缺乏参考标准,仍需完善。

Comparative study on nutrition-related indicators in preterm infants with different follow-up patterns from 6 to 12 months after birth

Objective To monitor serum 25-hydroxyvitamin D₃ 25-(OH)D₃],calcium(Ca),phosphorus (P),alkaline phosphatase (ALP),urea(UREA),prealbumin (PA) of regular and irregular follow-up model of premature infants from corrected age of 6 to 12 months after birth,so as to explore the effect of two follow-up models on nutritional status of premature infants and the safety. Methods A retrospective analysis of 143 premature infants in the Second Affiliated Hospital of Army Medical University from January 2015 to December 2017 was conducted.Totally 79 premature infants undergoing regular follow-up were assigned to group A,and 64 premature infants undergoing unscheduled follow-up were selected as group B.In the meantime,253 full-term healthy infants followed up in the pediatric care clinic were assigned to group C.Serum level of 25-(OH)D₃, Ca,ALP,P,UREA and PA were tested at the corrected age of 6 months to 12 months. Results 1) Serum 25-(OH) D₃,Ca and PA in group A and group C of premature infants were significantly higher than those in group B (P<0.05).Serum 25-(OH) D₃ in group A was significantly higher than that in group C (P<0.05).But there were no significant differences on serum ALP,P and UREA among group A,B and C.2) There were no poisoning cases of 25-(OH)D₃ in three groups.The most suitable 25-(OH)D₃ levels were found in group A and the least in group B. Conclusion 1) The incidence rates of serum 25-(OH)D₃ deficiency and hypoprealbuminemia are lower in preterm infants regularly followed up and fed according to the recommendation of child care.2) The feeding scheme for premature infants is supposed to be individualized.3) Some nutritional indicators of premature infants,such as alkaline phosphatase,lack reference criteria and need to be improved.