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目的探讨早产儿早期骨代谢生化指标状态变化,以及营养对其影响。方法选择2012年11月至2014年4月本院收治的胎龄30~35周早产儿,分别于生后24 h内及生后2周清晨8~9时采集静脉血,采用电化学发光法测定血清β-I型胶原羧基末端端肽(β-CTx)、骨钙素(OC)、Ⅰ型前胶原氨基端延长肽(PINP)水平,分析上述指标的动态变化及其与早期营养相关指标的关系。结果共纳入60例早产儿。生后24 h内血清β-CTx、OC、PINP水平之间无相关性(P>0.05);生后24 h内血清β-CTx与胎龄成负相关(r=-0.603,P<0.05),OC与胎龄成正相关(r=0.581,P<0.05),PINP水平与胎龄无相关(r=0.134,P>0.05)。生后2周血清β-CTX、OC、PINP水平均较生后24 h内显著升高,差异有统计学意义(P<0.05);生后2周与生后24 h内的差值Δβ-CTx与ΔOC成正相关(r=0.600,P<0.05),Δβ-CTx与ΔPINP无相关(r=0.045,P>0.05),ΔOC与ΔPINP无相关(r=0.110,P>0.05)。生后2周ΔOC与日均热卡、日均蛋白热卡比成正相关,与热卡累计缺失量成负相关(P<0.05),与日均奶量热卡、日均蛋白量、蛋白累计缺失量无相关(P>0.05);Δβ-CTx、ΔPINP与相关营养指标均无相关性(P>0.05)。结论早产儿生后24 h内血清OC与胎龄成正相关,β-CTx与胎龄成负相关;生后2周骨代谢处于活跃状态,血清β-CTx、OC、PINP水平显著升高。早期提供合理热卡和适宜的蛋白热卡比对骨的正常发育具有重要意义。
Objective To investigate the changes of biochemical markers of bone metabolism and the effects of nutrition on the early premature infants. Methods Preterm infants with gestational age of 30-35 weeks who were admitted to our hospital from November 2012 to April 2014 were enrolled in this study. Venous blood was collected within 24 hours after birth and 8 to 9 hours after birth 2 weeks after birth. Electrochemiluminescence The levels of β-CTx, OC and PINP in serum were measured. The dynamic changes of these indexes and their correlation with early nutrition Relationship. Results A total of 60 preterm infants were included. Serum levels of β-CTx, OC and PINP were not correlated with serum levels of 24-h postnatal (P> 0.05). There was a negative correlation between serum β-CTx and gestational age within 24 hours after birth (r = -0.603, There was a positive correlation between OC and gestational age (r = 0.581, P <0.05). There was no correlation between PINP and gestational age (r = 0.134, P> 0.05). The levels of serumβ-CTX, OC and PINP in serum at 2 weeks after birth were significantly higher than those within 24 hours after birth (P <0.05) CTx was positively correlated with ΔOC (r = 0.600, P <0.05). No correlation was found between Δβ-CTx and ΔPINP (r = 0.045, P> 0.05) and ΔOC was not correlated with ΔPINP (r = 0.110, P> 0.05). At 2 weeks after birth, ΔOC was positively correlated with daily calorie and daily caloric value, negatively correlated with total calorie deficit (P <0.05), and negative caloric average daily caloric content (P> 0.05). There was no correlation between Δβ-CTx and ΔPINP and related nutritional indexes (P> 0.05). Conclusion Serum OC was positively correlated with gestational age within 24 hours after birth, and β-CTx was negatively correlated with gestational age. Bone metabolism was active at 2 weeks after birth, and the levels of serum β-CTx, OC and PINP were significantly increased. Early provision of a reasonable heat card and the appropriate protein heat card than the normal development of bone is of great significance.