早期足量补充氨基酸复合维生素治疗早产儿宫外生长发育迟缓的研究

Study on early adequate supplementation of amino acid complex vitamins in the treatment of extrauterine growth retardation in premature infants

摘要

目的 探讨早期足量补充氨基酸复合维生素治疗早产儿宫外生长发育迟缓(EUGR)的有效性。方法 选取2021年9月至2023年4月在邯郸市第一医院出生及治疗的94例EUGR早产儿作为研究对象(迟缓组),根据干预方式的不同分为实验组(高剂量氨基酸复合维生素)及对照组(低剂量氨基酸联合维生素),观察两组患儿体格生长指标及血清实验室指标变化。选取同期本院出生的非EUGR早产儿58例作为正常组。收集患儿临床资料,Logistic回归模型分析早产儿EUGR发生的影响因素。结果 与对照组相比,实验组患儿体重增加速度、身长增加速度增加,恢复出生体重时间、住院时间缩短,差异有统计学意义(t值介于2.428~4.425之间,P<0.05);与对照组相比,实验组总蛋白、入院时前白蛋白、瘦素水平升高,差异有统计学意义(t值分别为5.421、3.550、6.323,P<0.05);与正常组相比,迟缓组胎龄较小,出生体重较轻,前白蛋白水平较低,窒息、机械通气占比较高,差异有统计学意义(χ²/t值介于3.436~13.462之间,P<0.05);多因素Logistic回归分析结果显示小胎龄、低出生体重、窒息、机械通气、入院时低前白蛋白均为早产儿EUGR发生的危险因素(OR值介于2.168~9.403之间,P<0.05)。结论 早期足量补充氨基酸复合维生素有利于EUGR早产儿体格生长;小胎龄、低出生体重、窒息、入院时低前白蛋白、机械通气均为早产儿EUGR发生的独立危险因素。

Abstract

Objective To explore the effectiveness of early and adequate supplementation of amino acid and vitamin complexes in treating extrauterine growth retardation (EUGR) in premature infants. Methods 94 premature infants with EUGR who were born and treated at Handan First Hospital from September 2021 to April 2023 were selected as the research subjects (delayed group). They were divided into the experimental group (high-dose amino acid and vitamin complex) and the control group (low-dose amino acid combined with vitamins) based on different intervention methods. The changes in physical growth indicators and serum laboratory indicators of the two groups of children were observed. 58 non-EUGR premature infants born in the same hospital during the same period were selected as the normal group. The clinical data of the children were collected, and the influencing factors of EUGR in premature infants were analyzed using the Logistic regression model. Results Compared with the control group, the weight gain rate and height gain rate of the children in the experimental group increased, and the time to regain birth weight and hospital stay were shortened, with statistically significant differences (t ranged from 2.428 to 4.425, P<0.05). Compared with the control group, the total protein, pre-admission prealbumin, and leptin levels in the experimental group increased, with statistically significant differences (t=5.421, 3.550, and 6.323 respectively, P<0.05). Compared with the normal group, the gestational age of the delayed group was smaller, the birth weight was lighter, the prealbumin level was lower, and the rates of asphyxia and mechanical ventilation were higher, with statistically significant differences (χ²/t ranged from 3.436 to 13.462, P<0.05). The results of the multivariate Logistic regression analysis showed that small gestational age, low birth weight, asphyxia, admission prealbumin level lower than normal, and mechanical ventilation were all independent risk factors for EUGR in premature infants (OR ranged from 2.168 to 9.403, P<0.05). Conclusion Early and adequate supplementation of amino acid and vitamin complexes is beneficial to the physical growth of premature infants with EUGR. Small gestational age, low birth weight, asphyxia, admission prealbumin level lower than normal, and mechanical ventilation are all independent risk factors for EUGR in premature infants.

关键词

氨基酸 / 维生素 / 早产儿 / 宫外生长发育迟缓 / 影响因素

Key words

amino acid / vitamin / premature infant / extrauterine growth retardation / influencing factor

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