Nagaya Ken, Tanaka Shinya, Kitajima Hiroyuki, Fujimura Masanori
Department of Pediatrics, Asahikawa Medical College, Midorigaoka-higashi, Asahikawa, Hokkaido, Japan.
Early Hum Dev. 2007 May;83(5):285-91. doi: 10.1016/j.earlhumdev.2006.06.002. Epub 2006 Aug 7.
Currently, there are no nutritional indices to predict cognitive function in extremely low-birth-weight (ELBW) infants.
To assess the neonatal blood urea nitrogen (BUN) values in ELBW infants according to their cognitive function at the corrected age of 36 months.
This was a retrospective study that assessed the neonatal factors affecting the developmental outcome in two groups "developmental quotient (DQ)> or =80" and "DQ<80", the groups were divided based on the DQ at the corrected age of 36 months. Between 1996 and 1999, 178 ELBW infants born at <28 weeks of gestation were admitted to our neonatal intensive care unit (NICU), of these, 32 died. Of the surviving 146 infants, 37 infants without any exclusion criteria (that would affect the cognitive function and BUN) except the nutritional factor, were assessed. Area under the curve (AUC) of corrected BUN (CBUN: BUN x 0.5/serum creatinine) from 28 to 84 days of life was used as an index of protein intake.
No significant differences were observed between the two groups with regard to the gestational age, birth weight, Z score of birth weight, and sex. However, compared to 15 infants with DQ<80, 22 infants with DQ> or =80 had significantly shorter duration of artificial ventilation and O(2) supplementation, a higher Apgar score at 5 min, and a higher AUC of CBUN. On multiple regression analysis, DQ> or =80 was observed to be significantly correlated with the AUC of CBUN (Odd's ratio 1.03, 95% confidence interval: 1.002-1.06).
The CBUN level would provide an estimate of adequate protein intake and the subsequent development of an ELBW infant.
目前，尚无营养指标可用于预测极低出生体重（ELBW）婴儿的认知功能。
根据36月龄矫正年龄时的认知功能，评估ELBW婴儿的新生儿血尿素氮（BUN）值。
这是一项回顾性研究，评估了影响两组“发育商（DQ）≥80”和“DQ<80”发育结局的新生儿因素，两组根据36月龄矫正年龄时的DQ进行划分。1996年至1999年期间，178例孕周<28周出生的ELBW婴儿入住我们的新生儿重症监护病房（NICU），其中32例死亡。在存活的146例婴儿中，评估了37例除营养因素外无任何排除标准（会影响认知功能和BUN）的婴儿。出生后28至84天的矫正BUN（CBUN：BUN×0.5/血清肌酐）曲线下面积（AUC）用作蛋白质摄入量指标。
两组在胎龄、出生体重、出生体重Z评分和性别方面未观察到显著差异。然而，与15例DQ<80的婴儿相比，22例DQ≥80的婴儿人工通气和吸氧持续时间显著更短，5分钟时Apgar评分更高，CBUN的AUC更高。多因素回归分析显示，DQ≥80与CBUN的AUC显著相关（优势比1.03，95%置信区间：1.002 - 1.06）。
CBUN水平可用于评估ELBW婴儿蛋白质摄入是否充足及其后续发育情况。
