目的 分析早产儿早期血清蛋白生化指标在评价早产儿营养状态的价值。方法 选择早产儿263例,将其中全部适于胎龄(AGA)早产儿(207例)分为28周≤GA≤34周组及34周＜GA＜37周组;将263例28周≤GA≤34周及34周＜GA＜37周两组早产儿分别分为小于胎龄(SGA)及AGA进行比较;根据出生体重分为≤2 000 g组,＞2 000 g组。所有早产儿于出生后24 h内采集静脉血2 ml,检测血清前白蛋白(PA)、白蛋白(ALB)、球蛋白(GLO)水平,并计算血清前白蛋白质量(SPMPA),统计所有早产儿住院时间。结果 小胎龄组SPMPA、ALB、GLO明显低于大胎龄组,差异具有统计学意义(P＜0.05),小胎龄组PA亦较低,但差异无统计学意义(P＞0.05);≤2 000 g组SPMPA、ALB显著低于＞2 000 g组,差异有统计学意义(P＜0.05),PA及GLO均较低,但差异无统计学意义(P＞0.05),SGA组SPMPA均明显低于AGA(P＜0.05);胎龄越小、体重越低,住院时间越长,且SGA住院时间明显增加(P＜0.05);SPMPA与出生体重呈明显正相关(r=0.540,P＜0.05)。结论 早产儿胎龄越小、体重越低,血清前白蛋白质量、白蛋白水平越低;SPMPA是评价早产儿成熟度及营养状况最敏感的指标,还可作为区分SGA和AGA的有效指标。

Objective To discuss the assessment value of early serum biochemical indexes to nutritional statue of the premature infant. Methods Totally 263 premature infants were selected,all appropriate for gestational age (AGA) premature infants(207) were divided into two groups based on their gestational age (GA):28≤GA≤34 weeks and 34＜GA＜37 weeks,and all premature infants of 28≤GA≤34 weeks and 34＜GA＜37 weeks were divided into SGA and AGA respectively.According to birth weight,all infants were divided into two groups that ≤2 000 g and ＞2 000 g.For all the infants,2 ml venous blood was collected within 24 hours after the birth in order to determine the prealbumin (PA),albumin (ALB) and globulin (GLO) levels,to calculate SPMPA and hospital stays. Results The SPMPA,ALB and GLO levels in the small gestational age (SGA) group were lower than the large gestational age (LGA) group,and the differences were statistically significant (P＜0.05),the PA level was also lower,but the difference was no statistically significant (P＞0.05).The SPMPA and ALB levels of ≤2 000 g group were lower than ＞2 000 g group,and the differences were statistically significant (P＜0.05),although PA and GLO levels were lower,but the differences were no statistically significant (P＞0.05).The SPMPA of SGA group was lower than that of AGA group (P＜0.05).The smaller the gestational age of the premature was,and the lower the birth weight was,the longer hospital stays was.The hospital stays of SGA was signifcantly increased (P＜0.05).SPMPA and birth weight showed positive correlation(r=0.540,P＜0.05). Conclusions The smaller the gestational age of the premature is,and the lower the birth weight is,the lower the SPMPA and ALB levels are.SPMPA is the most sensitive indicator to evaluate the maturity and nutritional status of the premature infant,and to distinguish SGA and AGA.