Pelegano J F, Rowe J C, Carey D E, LaBarre D J, Edgren K W, Lazar A M, Horak E
Department of Pediatrics, University of Connecticut Health Center, Farmington 06032.
J Pediatr Gastroenterol Nutr. 1991 Apr;12(3):351-5. doi: 10.1097/00005176-199104000-00011.
We hypothesized that retention of parenterally delivered calcium (Ca) and phosphorus (P) is affected by the ratio of the delivered minerals and that a 1.7:1 ratio would be optimal since this is the ratio of retention of these minerals by the fetus. Forty-one very low birth weight (VLBW) infants were randomly assigned to one of three total parenteral nutrition (TPN) solutions that were different only in their Ca:P ratios: 2:1 (76 mg/kg/day Ca and 38 mg/kg/day of P), and 1.3:1 (58 mg/kg/day Ca and 45 mg/kg/day P), and 1.3:1 (58 mg/kg/day of Ca and 45 mg/kg/day of P). Serum levels of calcium, phosphorus, and alkaline phosphatase, retentions of calcium and phosphorus and urinary cyclic AMP levels were measured after 48 h on the assigned Ca to P ratio. Calcium retentions were higher with the 2:1 and 1.7:1 ratios and phosphorus retentions were higher with the 1.3:1 and 1.7:1 ratios. The 1.7:1 ratio allowed for the highest absolute retention of both minerals and was the closest to published in utero accretion of calcium and phosphorus. The serum and urine studies demonstrated no abnormalities on any of the three ratios. Cyclic AMPs were not different among groups and were not elevated compared to previous reports suggesting that none resulted in parathyroid hormone (PTH) stimulation. We conclude that the 1.7:1 ratio is better than higher or lower ratios for delivery of calcium and phosphorus in TPN solutions at the quantities studied.
我们假设，肠胃外输送的钙（Ca）和磷（P）的潴留情况受所输送矿物质比例的影响，且1.7:1的比例最为理想，因为这是胎儿对这些矿物质的潴留比例。41名极低出生体重（VLBW）婴儿被随机分配至三种全肠胃外营养（TPN）溶液中的一种，这三种溶液仅在钙磷比例上有所不同：2:1（76毫克/千克/天钙和38毫克/千克/天磷）、1.3:1（58毫克/千克/天钙和45毫克/千克/天磷）以及1.3:1（58毫克/千克/天钙和45毫克/千克/天磷）。在按照指定的钙磷比例进行48小时治疗后，测量血清钙、磷和碱性磷酸酶水平、钙和磷的潴留情况以及尿中环磷酸腺苷（cAMP）水平。2:1和1.7:1比例时的钙潴留较高，1.3:1和1.7:1比例时的磷潴留较高。1.7:1的比例使两种矿物质的绝对潴留量最高，且最接近已发表的胎儿期钙和磷的蓄积量。血清和尿液研究表明，三种比例下均未出现异常情况。各实验组间的环磷酸腺苷水平无差异，与之前的报告相比也未升高，这表明均未导致甲状旁腺激素（PTH）的刺激。我们得出结论，在所研究的剂量下，对于TPN溶液中钙和磷的输送，1.7:1的比例优于更高或更低的比例。
