Aly Hany, Moustafa Mohamed F, Hassanein Sahar M, Massaro An N, Amer Hanna A, Patel Kantilal
Neonatology Department, The George Washington University Hospital & Children's National Medical Center, Washington, DC 20037, USA.
J Perinatol. 2004 May;24(5):305-9. doi: 10.1038/sj.jp.7211083.
Osteopenia of prematurity is a known source for morbidity in preterm infants. Premature infants have shown favorable outcomes in response to massage and physical activity. Whether such intervention can stimulate bone formation or decrease bone resorption is yet to be determined.
To test the hypothesis that massage combined with physical activity can stimulate bone formation and ameliorate bone resorption in premature infants.
DESIGN/METHODS: A prospective double-blinded randomized trial was conducted at the Neonatal Intensive Care Unit of Ain Shams University in Cairo, Egypt. Thirty preterm infants (28 to 35 weeks' gestation) were randomly assigned to either control group (Group I, n=15) or intervention group (Group II, n=15). Infants in the intervention group received a daily protocol of combined massage and physical activity. Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) were used as indices for bone formation and resorption, respectively. PICP and Pyd were measured at enrollment and at discharge for all subjects. t-Test, ANOVA and linear regression analysis were used for statistical analyses.
There was no difference between groups I and II in gestational age (32.1+/-1.8 vs 31.5+/-1.4 weeks) or birth weight (1.429+/-0.148 vs 1.467+/-0.132 g). In the control group, serum PICP decreased over time from 82.3+/-8.5 to 68.78+/-14.6 (p<0.01), while urinary Pyd increased from 447.7+/-282.8 to 744.9+/-373.6 (p<0.01) indicating decreased bone formation and increased bone resorption, respectively. In the intervention group, serum PICP increased over time from 62.5+/-13.8 to 73.84+/-12.9 (p<0.01). Urinary Pyd also increased over time from 445.7+/-266.5 to 716.8+/-301.8 (p<0.01). In a linear regression model including gestational age and intervention, serum PICP increased significantly in the intervention group (regression coefficient 18.8+/-4.6, p=0.0001) while urinary Pyd did not differ between groups (regression coefficient=5.6+/-114.3, p=0.961).
A combined massage and physical activity protocol improved bone formation (PICP) but did not affect bone resorption (Pyd). Pyd increased over time in both groups, possibly due to continuous bone resorption and Ca mobilization.
早产骨质减少是早产儿发病的一个已知原因。早产儿对按摩和体育活动已显示出良好的反应结果。这种干预是否能刺激骨形成或减少骨吸收尚待确定。
检验按摩联合体育活动能刺激早产儿骨形成并改善骨吸收这一假设。
设计/方法：在埃及开罗艾因夏姆斯大学新生儿重症监护病房进行了一项前瞻性双盲随机试验。30名早产儿（孕龄28至35周）被随机分为对照组（第一组，n = 15）或干预组（第二组，n = 15）。干预组婴儿接受每日按摩和体育活动联合方案。血清I型胶原C末端前肽（PICP）和尿胶原吡啶啉交联物（Pyd）分别用作骨形成和骨吸收的指标。在入组时和出院时对所有受试者测量PICP和Pyd。采用t检验、方差分析和线性回归分析进行统计分析。
第一组和第二组在孕龄（32.1±1.8对31.5±1.4周）或出生体重（1.429±0.148对1.467±0.132 g）方面无差异。在对照组中，血清PICP随时间从82.3±8.5降至68.78±14.6（p<0.01），而尿Pyd从447.7±282.8增至744.9±373.6（p<0.01），分别表明骨形成减少和骨吸收增加。在干预组中，血清PICP随时间从62.5±13.8增至73.84±12.9（p<0.01）。尿Pyd也随时间从445.7±266.5增至716.8±301.8（p<0.01）。在一个包括孕龄和干预的线性回归模型中，干预组血清PICP显著增加（回归系数18.8±4.6，p = 未找到相关内容），而两组间尿Pyd无差异（回归系数 = 5.6±114.3，p = 0.961）。
按摩和体育活动联合方案改善了骨形成（PICP），但未影响骨吸收（Pyd）。两组中Pyd均随时间增加，可能是由于持续的骨吸收和钙动员。
