论文下载：早产儿早期不同剂量氨基酸应用策略的对照研究

早产儿早期不同剂量氨基酸应用策略的对照研究(1)

http://www.100md.com 2011年9月25日周建福曾仁和连文昌等

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     【摘要】目的探讨早产儿早期应用不同剂量氨基酸的近期疗效和耐受情况。方法将2010年1月至2011年6月间出生24 h内体质量1000～2000 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2组。大剂量组(HP)于生后24 h内输注20 g/(kg•d)氨基酸起，每天增加085 g/kg，预期峰值37 g/(kg•d)；低剂量组(LP)于出生24 h内输注05 g/(kg•d)氨基酸起，每天增加05 g/kg，预期峰值37 g/(kg•d)。结果两组早产儿一般情况相似。大剂量组第1天RBP和第3天PA高于低剂量组，差异有统计学意义(P均<005)；大剂量组早产儿体质量下降百分比少于低剂量组，差异有统计学意义(P<005)；大剂量组头围增长大于低剂量组，差异有统计学意义(P<005)；大剂量组早产儿肠内营养能量达4184 KJ/(kg•d)天数、恢复出生体质量天数和体质量达到2000 g天数均少于低剂量组，差异有统计学意义(P均<005)。安全性指标2组没有差异。结论早产儿生后24 h内可以耐受输注大剂量20 g/(kg•d)氨基酸，能改善营养状况，增加喂养的耐受性和促进早产儿生长。

    【关键词】婴儿；早产儿；胃肠外营养；氨基酸

    Early application of differentdoses of amino acids supplementation in preterm infantsZHOU Jianfu, ZEN Renhe, LIAN Wenchang,et al.Affiliated Putian Hospital of Nanfang Medical University, Affiliated Hospital of Putian College, Putian 351100, China

    【Abstract】ObjectiveTo evaluate the efficacy and safety of parenteral nutrition with differentdose amino acid in premature infants MethodsPremature infants (birth weight 1000～2000 g) recruited into the study were randomized into two groups High group (HP):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).Low group (LP):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).ResultsTotally 107 premature infants were recruited:HP 56 and LP 51There were no significant differences in demographic or clinical characteristics among the 2 groups Mean serum RBP (D1) and PA (D3) levels were significantly higher in HP group than in LP group(P<005).HP group showed lower weight loss%than in LP group，head circumference quickly growth than in LP group(P<005)，shorter length days to tolerate 4184 KJ /(kg•d) enteral nutrition, days to regain birth weigh and reach 2000 g than in LP group(P<005).There were no significant differences in the levels of blood ammonia，PH，BUN，Cr，ALT，AST and GLU ConclusionEarly administration of intravenous amino acid [20 g/(kg•d)] significantly improves in nutrition of premature infants,growth and the tolerance of enteral feeding ......

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