【目的】 探讨不同喂养方式对出院后早产儿体格发育及生化指标的影响,为临床早产儿合理喂养指导提供依据。 【方法】 早产儿91例,出生体重均在1 500 g以上。按喂养方式分为5组:1组为早产儿配方,2组为足月儿配方;3组为早产儿配方+母乳;4组为母乳;5组为足月儿配方+母乳。在矫正月龄4~6个月时测量身长、体重,计算身长、体重的Z值,测定血清总蛋白、白蛋白、微量元素等指标。 【结果】 4组身长Z值为负值,体重Z值亦低于其他各组,但差异无统计学意义(P>0.05);其余各组体重和身长的Z值均为正值,组间差异无统计学意义(P>0.05)。4组血清尿素氮低于其余各组(P<0.05),2组血清尿素氮显著高于3、4、5组(P<0.05),和1组之间差异无统计学意义(P=0.126);1组和5组的白蛋白水平之间差异无统计学意义(P=0.947),但均明显高于3组和4组(P<0.05)。其余各血清学指标之间差异无统计学意义(P>0.05)。 【结论】 1)纯母乳喂养儿体格发育和血清白蛋白水平较其他喂养方式低,提示单纯母乳不能完全满足早产儿早期生长发育需要;2)足月儿配方奶喂养的早产儿血清尿素氮偏高,其机制和远期影响有待进一步探讨。

【Objective】 To investigate the effects of feeding in different ways on physical development and serum index of preterm infants. 【Methods】 91 preterm infants whose birth weights were all above 1 500 g. Infants were divided into 5 groups by following feeding ways: preterm-infant formula; term-infant formula; preterm-infant formula and breast milk; breast milk; term-infant formula and breast milk. Weights, lengths were measured at 4~6 months adjusted by gestational age.Z-score of weights and lengths were calculated. Serum total protein, albumin, and micronutrients etc were detected. 【Results】 The Z-score of weights and lengths in Group 4 were blow zero, and lower than other groups. But the differences were not significant (P>0.05). The serum levels of BUN in Group 4 was significant lower than other groups (P<0.05) and was significant higher in Group 2 than Group 3, Group 4, Group 5 (P<0.05). The serum levels of albumin in Group 1 and Group 5 were significant higher than other groups (P<0.05), but were similar between the two group (P=0.947). There were no significant differences in other serum index levels among the groups (P>0.05). The levels of serum BUN were correlated with the Z-score of length (r=0.228, P=0.04). 【Conclusion】 1) Exclusive breast feeding can not provide enough nutrients for matching the early growth and development of preterm infants; 2) Further study will be needed to investigate the mechanisms and long effects of high serum BUN levels in preterm infants feeding with term-infant formula.