
不同胎龄及出生体重早产儿血游离肉碱变化特点
齐志业, 段江, 王琼, 姚勤, 钟庆华, 张彩营, 梁琨
中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (6) : 562-566.
不同胎龄及出生体重早产儿血游离肉碱变化特点
Levels of blood free carnitine in preterm infants with different gestational ages and birth weights
目的检测不同胎龄及出生体重早产儿血游离肉碱(FC)浓度,为制定早产儿FC补充治疗方案提供依据。方法选取3 368例早产儿为研究对象。根据胎龄(GA)分为超早产(EPTB,GA<28周)组(n=39)、极早产(VPTB,28≤GA < 32周)组(n=405)、中期早产(MPTB,32≤GA<34周)组(n=507)、晚期早产(LPTB,34≤GA<37周)组(n=2 417);根据出生体重(BW)分为超低出生体重(ELBW,BW < 1 000 g)组(n=36)、极低出生体重(VLBW,1 000 g≤BW < 1 500 g)组(n=387)、低出生体重组(LBW,1 500 g≤BW < 2 500 g)组(n=1 873)、正常出生体重(NBW,2 500 g≤BW≤4 000 g)组(n=1 072)。于生后72 h~7 d内采血进行FC浓度测定并进行比较。结果 EPTB、VPTB组FC浓度明显高于MPTB、LPTB组(P < 0.05),MPTB组FC浓度明显高于LPTB组(P < 0.05);胎龄越小,FC的95%医学参考范围下限越高。ELBW、VLBW组FC浓度明显高于LBW、NBW组(P < 0.05),LBW组FC浓度明显高于NBW组(P < 0.05);出生体重越低,FC的95%医学参考范围下限越高。结论极/超早产儿、极/超低出生体重儿血FC浓度明显升高,并且随着胎龄及出生体重的增加呈明显下降的趋势。
Objective To examine blood concentrations of free carnitine (FC) in preterm infants with different gestational ages (GA) and birth weights (BW). Methods A total of 3 368 preterm infants were enrolled as subjects. According to GA, they were divided into extremely preterm birth (EPTB) group (GA <28 weeks; n=39), very preterm birth (VPTB) group (28 ≤ GA <32 weeks; n=405), moderately preterm birth (MPTB) group (32 ≤ GA < 34 weeks; n=507), and late preterm birth (LPTB) group (34 ≤ GA <37 weeks; n=2 417); according to BW, they were divided into extremely low birth weight (ELBW) group (BW <1 000 g; n=36), very low birth weight (VLBW) group (1 000 g ≤ BW < 1 500 g; n=387), low birth weight (LBW) group (1 500 g ≤ BW < 2 500 g; n=1 873), and normal birth weight (NBW) group (2 500 g ≤ BW <4 000 g; n=1 072). Blood concentrations of FC were measured between 72 hours and 7 days after birth. Results The EPTB and VPTB groups had significantly higher FC concentrations than the MPTB and LPTB groups (P < 0.05), and the MPTB group had significantly higher FC concentrations than the LPTB group (P < 0.05). The lower limit of the 95% medical reference range of FC increased with the reduction in GA. The ELBW and VLBW groups had significantly higher FC concentrations than the LBW and NBW groups (P < 0.05). The LBW group had significantly higher FC concentrations than the NBW group (P < 0.05). The lower limit of the 95% medical reference range of FC increased with the reduction in BW. Conclusions There is a significant increase in blood FC concentrations in very/extremely preterm infants and very/extremely low birth weight infants, and tend to decrease with the increases in GA and BW.
游离肉碱 / 胎龄 / 出生体重 / 医学参考范围 / 早产儿
Free carnitine / Gestational age / Birth weight / Medical reference range / Preterm infant
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云南省高层次卫生技术人才培养(学科带头人)基金资助项目(D-201609)。