肠内补充 L-瓜氨酸可安全有效地增加早产儿血浆精氨酸和瓜氨酸水平：一项随机试验。

Enteral L-citrulline supplementation in preterm infants is safe and effective in increasing plasma arginine and citrulline levels-a pilot randomized trial.

机构信息

Department of Neonatology, Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA.

Department of Pediatrics, Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

J Perinatol. 2024 May;44(5):702-708. doi: 10.1038/s41372-023-01761-x. Epub 2023 Aug 28.

DOI:10.1038/s41372-023-01761-x

PMID:37640809

Abstract

OBJECTIVE

Deficiencies of citrulline and arginine have been associated with adverse outcomes in preterm-infants and data regarding enteral supplementation in preterm infants is limited.

STUDY DESIGN

This randomized -trial [NCT03649932] included 42 preterm infants (gestational age ≤33 weeks) randomized to receive enteral L-citrulline in low (100 mg/kg/day), medium (200 mg/kg/day) and high-dose (300 mg/kg/day) groups for 7 days. Plasma citrulline and arginine levels were obtained pre-and-post supplementation and efficacy was determined by a significant increase in levels after supplementation. A p < 0.05 was considered significant. Safety monitoring included blood-pressure-monitoring as well as complications and death during hospitalization.

RESULTS

A total of 40/42 (95%) of the recruits completed the 7-day supplementation with no adverse events. Plasma-citrulline levels increased significantly in all three groups while plasma-arginine levels increased significantly in the high-dose group.

CONCLUSION

Enteral L-citrulline supplementation in preterm infants is safe and effective in increasing plasma citrulline and arginine levels.

CLINICAL TRIAL REGISTRATION

NCT03649932 https://clinicaltrials.gov/ct2/show/NCT03649932 .

摘要

目的

精氨酸和瓜氨酸缺乏与早产儿不良结局有关，而关于早产儿肠内补充精氨酸的数据有限。

研究设计

本随机对照试验[NCT03649932]纳入了 42 例早产儿（胎龄≤33 周），随机分为三组，分别接受低剂量（100mg/kg/天）、中剂量（200mg/kg/天）和高剂量（300mg/kg/天）肠内补充 L-瓜氨酸，为期 7 天。在补充前后测量血浆瓜氨酸和精氨酸水平，以补充后水平显著升高为有效。p 值<0.05 被认为具有统计学意义。安全性监测包括血压监测以及住院期间的并发症和死亡。