肠外补充谷氨酰胺对早产儿的影响。

Effect of parenteral glutamine supplementation in premature infants.

作者信息

Li Zheng-hong, Wang Dan-hua, Dong Mei

机构信息

Department of Paediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Chin Med J (Engl). 2007 Jan 20;120(2):140-4.

PMID:17335657

Abstract

BACKGROUND

Glutamine, proposed to be conditionally essential for critically ill patients, is not added routinely to parenteral amino acid formulations for premature infants and is provided in only small quantities by the enteral route when enteral feeding is low. Parenteral feeding is the basic way of nutrition in the first days of life of premature infants. In this study, we evaluated the effects of glutamine supplemented parenteral nutrition for premature infants on growth and development, feeding toleration, and infective episodes.

METHODS

From December 2002 to July 2006, 53 premature infants were given either standard or glutamine supplemented parenteral nutrition for more than 2 weeks. Twenty-eight infants were in glutamine supplemented group, whose gestational age (31.4 +/- 2.0) weeks, birth weight range (1386 +/- 251) g; twenty-five infants were in control group, gestational age (31.1 +/- 1.7) weeks, with birth weight range (1346 +/- 199) g. There were no differences between the two groups. Various growth and biochemical indices were monitored throughout the duration of hospital stay. Data between groups were analyzed with Student's t test. Nonparametric data were analyzed using a Chi-square test. A two-tailed P value < 0.05 was considered statistically significant.

RESULTS

The level of serum albumin was lower in the glutamine groups on the second week (3.0 vs 3.2 g/dl, P = 0.028), and blood urea nitrogen was higher in glutamine groups on the fourth week (8.1 vs 4.9 mg/dl, P = 0.014), but normal. Glutamine group infants took fewer days to regain birth weight (8.1 vs 10.4 days, P = 0.017), required fewer days on parenteral nutrition (24.8 vs 30.8 days, P = 0.035), with shorter stays in hospital (32.1 vs 38.6 days, P = 0.047). Episodes of hospital acquired infection in glutamine supplemented infants were lower than that in control group (0.96 vs 1.84 times, P = 0.000).

CONCLUSION

Parenteral glutamine supplementation in premature infants can shorten days on parenteral nutrition and length of stay in hospital, and decrease hospital acquired infection episodes.

摘要

背景

谷氨酰胺被认为对危重症患者具有条件必需性，但在早产儿的肠外氨基酸制剂中并未常规添加，且当肠内喂养量较低时，通过肠内途径提供的量也很少。肠外营养是早产儿出生后最初几天的基本营养方式。在本研究中，我们评估了补充谷氨酰胺的肠外营养对早产儿生长发育、喂养耐受性和感染性疾病的影响。

方法

2002年12月至2006年7月，53例早产儿接受标准或补充谷氨酰胺的肠外营养2周以上。补充谷氨酰胺组28例婴儿，胎龄（31.4±2.0）周，出生体重范围（1386±251）g；对照组25例婴儿，胎龄（31.1±1.7）周，出生体重范围（1346±199）g。两组间无差异。在住院期间监测各种生长和生化指标。组间数据采用Student's t检验进行分析。非参数数据采用卡方检验进行分析。双侧P值<0.05被认为具有统计学意义。

结果

补充谷氨酰胺组在第2周时血清白蛋白水平较低（3.0对3.2g/dl，P = 0.028），在第4周时血尿素氮水平较高（8.1对4.9mg/dl，P = 0.014），但均在正常范围内。补充谷氨酰胺组婴儿恢复出生体重所需天数较少（8.1对10.4天，P = 0.017），肠外营养所需天数较少（24.8对30.8天，P = 0.035），住院时间较短（32.1对38.6天，P = 0.047）。补充谷氨酰胺的婴儿医院获得性感染发生率低于对照组（0.96对1.84次，P = 0.000）。