出生体重＜1 500 g早产儿钙磷及维生素D摄入与骨代谢相关指标的研究
Calcium,phosphorus,vitamin D intake and bone metabolism in premature infants with birth weight＜1 500 g
姜静婧 1李正红 1王晨1
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院儿科,北京 100730
- 折叠
摘要
目的 探讨极低和超低出生体重早产儿住院期间钙磷、维生素D摄入情况及其与骨代谢指标的关系.方法 选择2019年1月至2021年12月北京协和医院新生儿重症监护病房收治的极低和超低出生体重早产儿进行回顾性分析,计算生后第1～4周钙磷及维生素D制剂日均摄入量及占推荐量的比值,收集生后第1～4周血碱性磷酸酶、血钙、血磷及血清25-羟维生素D等骨代谢相关指标资料,并分析其相关性.结果 共纳入101例早产儿,其中男52例,女49例,胎龄(29.0±2.5)周,出生体重(1 128±236)g,住院时间45.0(35.0,64.0)d,口服维生素D制剂起始日龄为生后第6.0(4.0,8.0)天,口服钙剂起始日龄为生后第9.0(5.5,11.0)天,加用母乳强化剂起始日龄为生后第14.0(11.0,20.0)天.生后第1～4周钙剂、维生素D日均摄入总量逐渐增加,以欧洲儿科营养指南建议为标准,生后第1～4周分别有1.0％、62.4％、88.1％、91.1％早产儿达到钙剂最低推荐摄入量,52.5％、41.6％、63.3％、82.2％早产儿达到磷剂最低推荐摄入量,1.0％、47.5％、73.3％、87.1％早产儿达到维生素D最低推荐摄入量.生后第2～4周血钙、血碱性磷酸酶升高,血磷先升后降.双变量相关分析显示生后第1周钙日均摄入量与生后第3、4周碱性磷酸酶呈负相关,第1、2周维生素D日均摄入量与生后第3、4周碱性磷酸酶呈负相关.结论 应加强极低和超低出生体重早产儿生后第1周钙及前2周维生素D的补充.
Abstract
Objective To study calcium(Ca),phosphorus(P)and vitamin D(VitD)intake in very/extremely low birth weight premature infants during hospitalization and their correlation with bone metabolism related indicator.Methods From January 2019 to December 2021,clinical data of premature infants admitted into NICU of our hospital were retrospectively collected,including average daily intakes(ADIs)of Ca,P and VitD within 1～4 weeks after birth.The ratio of ADIs to the recommended amount was calculated.Bone metabolism-related indicators including blood alkaline phosphatase(ALP),Ca,P and 25-hydroxyvitamin D[25(OH)D]were also collected and the correlations were analyzed.Results A total of 101 premature infants were enrolled,including 52 males and 49 females,with gestational age(29.0±2.5)weeks and birth weight(1128±236)g.The duration of hospital stay was 45.0(35.0,64.0)d.Oral VitD supplementation was initiated on d 6.0(4.0,8.0)after birth,oral Ca preparations was on d 9.0(5.5,11.0)and breast milk fortifier on d 14.0(11.0,20.0).ADIs of Ca and VitD increased gradually from 1 week to 4 weeks after birth.According to the recommendations of European Pediatric Nutrition Guidelines,1.0％,62.4％,88.1％and 91.1％premature infants reached the minimum recommended Ca intake and 52.5％,41.6％,63.3％and 82.2％reached the minimum recommended P intake.From 1 week to 4 weeks,blood Ca and ALP increased,while P firstly increased and then decreased.Correlation analysis showed that ADI of Ca in 1 week was negatively correlated with ALP in 3 weeks and 4 weeks,and ADI of VitD in 1 week and 2 weeks was negatively correlated with ALP in 3 weeks and 4 weeks.Conclusions Supplementation of Ca in the first week and VitD in the first two weeks of life should be strengthened in very/extremely low birth weight premature infants.
关键词
早产儿/骨代谢/维生素D摄入/钙磷摄入Key words
Premature infant/Bone metabolism/Vitamin D intake/Calcium and phosphorus intake引用本文复制引用
基金项目
中央高水平医院临床科研专项(2022-PUMCH-B-077)
出版年
2024
NETL
NSTL
万方数据