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目的 寻找新生儿营养评价的生化指标。 方法 以放射免疫分析试验测定血清胰岛素样生长因子 I(IGF- )、以酶联免疫吸附试验测定视黄醇结合蛋白 (RBP)和前白蛋白 (PA) ,分别按营养状况、小于胎龄儿 (SGA)和适于胎龄儿 (AGA)进行分组比较。 结果 2 4例营养不良 SGA的IGF- 、RBP和 PA的水平分别为 (80± 14) μg/ L、(2 1± 7) μg/ L 和 (35± 2 4) m g/ L,显著低于 2 5例营养正常 SGA的 (95± 2 8) μg/ L、(2 9± 14) mg/ L 和 (6 5± 34) m g/ L(P<0 .0 5～ 0 .0 0 1) ;19例营养不良 AGA相应的 (81± 17) μg/ L、(2 5± 12 ) m g/ L 和 (10 7± 17) m g/ L 也显著低于 16例营养正常 AGA的 (10 0± 32 ) μg/ L、(32± 8) mg/ L 和 (198± 6 8) m g/ L(P<0 .0 5～ 0 .0 0 1)。 结论 IGF- 、RBP和PA可作为新生儿营养评价的生化指标 ,其敏感性高、不受胎龄和日龄影响 ,便于疗效评价 ,是诊断营养不良时形态指标无法代替的。两类指标联合应用才能使诊断更完善。
Objective To find the biochemical indexes of nutritional evaluation of newborn. Methods Serum insulin - like growth factor I (IGF - I) was measured by radioimmunoassay (RIA), and RBP and PA were determined by enzyme - linked immunosorbent assay (ELISA) (SGA) and gestational age (AGA) for group comparison. Results The level of IGF-, RBP and PA in 24 cases of malnutrition SGA were (80 ± 14) μg / L, (21 ± 7) μg / L and (35 ± 2 4) mg / L, respectively, (95 ± 28) μg / L, (29 ± 14) mg / L and (65 ± 34) mg / L (P <0.05-0.0.01) (81 ± 17) μg / L, (25 ± 12) mg / L and (10 7 ± 17) mg / L, respectively, of 19 patients with malnourished AGA were significantly lower than those of 16 normal AGA patients 32) μg / L, (32 ± 8) mg / L and (198 ± 6 8) mg / L, respectively. Conclusion IGF-, RBP and PA can be used as biochemical indicators of nutritional assessment of neonate. It has high sensitivity and can not be affected by gestational age and age. It is convenient for the evaluation of curative effect and can not be replaced by morphological indexes in the diagnosis of malnutrition. Two types of indicators can be combined to make the diagnosis more perfect.