摘要
目的 探讨早产小于胎龄儿（SGA）与适于胎龄儿（AGA）住院期间生长代谢的差异.方法 回顾性分析我院2008年1月至2012年12月收治的胎龄28 ～ 34周早产儿病例,根据胎龄与出生体重的关系分为SGA组与AGA组,比较两组早产儿一般情况、体格增长、血生化指标及合并症等.结果 纳入研究的早产儿共164例,SGA组78例,AGA组86例.2组早产儿入院胎龄、性别、发生呼吸窘迫综合征的比例、恢复出生体重日龄等差异均无统计学意义（P＞0.05）.SGA组与AGA组相比,窒息比例高（25.6％比12.8％）,住院时间长[36.5（28,45.5）天比28（22,36）天],肠外营养时间长[26（19,35）天比22（16,30）天],差异有统计学意义（P＜0.05）.恢复出生体重后,SGA组与AGA组相比平均每日体重增长速率快[（20.6＆#177;3.3） g/（kg＆#183; d）比（18.4＆#177;3.8）g/（kg＆#183;d）],每周头围增长速度快[（0.71＆#177;0.25） cm比（0.55＆#177;0.26） cm],差异有统计学意义（P＜0.05）,每周身长增长速度差异无统计学意义（P＞0.05）.SGA组前白蛋白低于AGA组,胆汁酸高于AGA组,败血症和慢性肺疾病发生率均高于AGA组（20.5％比9.3％,11.5％比1.2％）,差异均有统计学意义（P＜0.05）,早产儿视网膜病和坏死性小肠结肠炎发生率差异无统计学意义（P＞0.05）.结论 SGA早产儿恢复出生体重后生长速率及头围增长速度快于AGA早产儿,但身长增长速度无差异;SGA早产儿出生及出院时血前白蛋白水平均低于AGA早产儿;SGA早产儿更易发生胆汁淤积、败血症及慢性肺疾病.
Objective To explore the possible differences of growth and metabolic patterns between SGA and AGA preterm infants during hospital stays. Methods Premature infants born at gestational age between 28 weeks and 34 weeks,admitted to the NICU of PUMCH from Jan. 2008 to Dec. 2012,were enrolled and were divided into SGA and AGA groups. General information,growth patterns,biochemical indexes and complications were compared. Results Total of 164 premature infants,including 91male and 73 female,were enrolled. Among them,78 infants were in the SGA group and 86 infants were in the AGA group. No statistically significant difference( P > 0. 05) was found in gestational age,gender,occurrence of respiratory distress syndrome( RDS) and days needed to regainbirth weight between the two groups. Comparing to the infants in the AGA group,those in the SGA group had higher occurrence of asphyxia( 25. 6% vs. 12. 8%),longer duration of hospital stay [36. 5( 28,45. 5) d vs. 28( 22,36) d],and longer course of parenteral nutrition [26( 19,35) d vs. 22( 16,30) d]( P <0. 05). Interestingly,infants in the SGA group had higher rate of weight growth after regained birth weight [( 20. 6 ± 3. 3) g /( kg·d) vs.( 18. 4 ± 3. 8) g /( kg·d) ],and faster weekly head circumference growth [( 0. 71 ± 0. 25) cm vs.( 0. 55 ± 0. 26) cm] than the infants in the AGA group( P < 0. 05);however,no difference on weekly rate of length growth was found between the two groups. Infants in the SGA group also had lower level of serum prealbumin( P < 0. 01),higher level bile acids than the levels in the AGA infants( P < 0. 05). Furthermore,infants in the SGA group showed significantly higher risk of developing sepsis( 20. 5% vs. 9. 3%,P < 0. 05) and chronic lung disease( CLD)( 11. 5% vs.1. 1%,P < 0. 01), while the occurrence of retinopathy of prematurity( ROP) and necrotizing enterocolitis( NEC) revealed no difference( P > 0. 05). Conclusions Comparing to the AGA premature infants,SGA premature infants had higher rate of weight growth after regained birth weight,faster rate of weekly head circumference growth,lower serum prealbumin level and higher risk of developing cholestasis,sepsis and chronic lung diseases.
出处
《中国新生儿科杂志》
CAS
2014年第2期73-77,共5页
Chinese Journal of Neonatology
关键词
小于胎龄儿
适于胎龄儿
婴儿
早产
生长和发育
Small for gestational age
Appropriate for gestational age
Infant,premature
Growth and development
