Chessex P, Pineault M, Brisson G, Delvin E E, Glorieux F H
Centre de recherche, Hôpital Sainte-Justine, Montreal, Quebec, Canada.
J Pediatr. 1990 May;116(5):765-72. doi: 10.1016/s0022-3476(05)82669-1.
Because the monobasic potassium phosphate salt (monobasic) improves the solubility of calcium and phosphorus in amino acid plus dextrose solutions, compared with the current mixtures of monobasic plus dibasic salts (dibasic), we tested the bioavailability and clinical effects of monobasic in 16 parenterally fed low birth weight infants at standard (n = 8) and high levels (n = 8) of mineral intakes. A constant infusion of macronutrients and vitamin D was provided in a crossover design of two four-day periods. With standard intakes of calcium (35 mg/kg/day, 0.9 mmol/kg/day) and phosphorus (30 mg/kg/day, 1 mmol/kg/day), there was no difference between monobasic and dibasic regimens on balance data or plasma biochemical monitoring (calcium, phosphorus, pH, carbon dioxide pressure, base excess, 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D). With the use of the monobasic regimen, the mineral intakes were doubled without precipitation in the infusate: calcium, 70 mg/kg/day (1.8 mmol/kg/day), and phosphorus, 55 mg/kg/day (1.7 mmol/kg/day). This led to increased apparent retention of both calcium (63 +/- 5 mg/kg/day, 1.58 +/- 0.12 mmol/kg/day) and phosphorus (52 +/- 4 mg/kg/day, 1.67 +/- 0.14 mmol/kg/day) compared with that for standard levels of mineral intake. The improvement of calcium-phosphorus balance was accompanied by more severe calciuria (9 +/- 2 mg/kg/day, 0.2 +/- 0.05 mmol/kg/day) and by metabolic compensation for an increased acid load. In addition to the possibility of exceeding the buffering capacity of the infant, this relative acidosis could also be evidence of improved bone mineralization.
由于磷酸二氢钾盐（磷酸二氢盐）可提高钙和磷在氨基酸加葡萄糖溶液中的溶解度，与目前磷酸二氢盐加磷酸氢盐（磷酸氢盐）的混合物相比，我们在16例接受肠外营养的低出生体重儿中，按照标准（n = 8）和高水平（n = 8）矿物质摄入量，测试了磷酸二氢盐的生物利用度和临床效果。在两个为期四天的交叉设计中，持续输注常量营养素和维生素D。在标准钙摄入量（35 mg/kg/天，0.9 mmol/kg/天）和磷摄入量（30 mg/kg/天，1 mmol/kg/天）的情况下，磷酸二氢盐方案与磷酸氢盐方案在平衡数据或血浆生化监测（钙、磷、pH值、二氧化碳分压、碱剩余、1,25-二羟维生素D、25-羟维生素D）方面没有差异。使用磷酸二氢盐方案时，矿物质摄入量增加一倍而输注液中无沉淀：钙，70 mg/kg/天（1.8 mmol/kg/天），磷，55 mg/kg/天（1.7 mmol/kg/天）。与标准矿物质摄入水平相比，这导致钙（63±5 mg/kg/天，1.58±0.12 mmol/kg/天）和磷（52±4 mg/kg/天，1.67±0.14 mmol/kg/天）的表观潴留增加。钙磷平衡的改善伴随着更严重的尿钙排泄（9±2 mg/kg/天，0.2±0.05 mmol/kg/天）以及对增加的酸负荷的代谢代偿。除了可能超过婴儿的缓冲能力外，这种相对酸中毒也可能是骨矿化改善的证据。
