Clark R H, Chace D H, Spitzer A R
Pediatrix-Obstetrix Center for Research, Education and Quality, Pediatrix Medical Group, Sunrise, FL, USA.
J Perinatol. 2017 May;37(5):566-571. doi: 10.1038/jp.2016.253. Epub 2017 Jan 12.
To describe the influence that of l-carnitine supplementation on acylcarnitine (AC) profiles and hospital outcomes in premature infants.
This study is a secondary analysis of previously reported work. Metabolic profiles were obtained using standard newborn techniques on infants born between 23 and 31 completed weeks of gestation. The profiles were drawn within the first 24 h after birth and on approximately days 7, 28 and 42 of life, or at the time of discharge. A single, central, contract laboratory analyzed and managed the samples.
We studied 995 patients; none was subsequently diagnosed with an inborn error of metabolism. l-Carnitine was added to parenteral nutrition in 390 (39%) study subjects; 592 (60%) did not receive supplementation. Non-supplemented infants were more likely to develop low levels of free carnitine (FC; <7 μm) on day 28; (41% vs 5%, P<0.01); and FC values were lower on day 7. Despite higher levels of FC and fewer patients with significant carnitine deficiencies, we found no evidence that l-carnitine supplementation was associated with improved short-term hospital outcomes.
l-Carnitine supplementation is common in prematurely born neonates and is associated with higher carnitine levels, but is not associated with improved short-term hospital outcomes.
描述补充左旋肉碱对早产儿酰基肉碱（AC）谱及住院结局的影响。
本研究是对先前报道工作的二次分析。采用标准新生儿技术获取妊娠23至31足周出生婴儿的代谢谱。这些谱在出生后24小时内以及生命的大约第7、28和42天或出院时采集。由一个中央合同实验室分析和管理样本。
我们研究了995例患者；随后均未被诊断为先天性代谢缺陷。390例（39%）研究对象在肠外营养中添加了左旋肉碱；592例（60%）未接受补充。未补充的婴儿在第28天更易出现游离肉碱（FC）水平低（<7μm）的情况（41%对5%，P<0.01）；且第7天时FC值更低。尽管补充组FC水平较高且严重肉碱缺乏的患者较少，但我们没有发现证据表明补充左旋肉碱与改善短期住院结局相关。
补充左旋肉碱在早产新生儿中很常见，且与较高的肉碱水平相关，但与改善短期住院结局无关。
