晚期早产儿血中氨基酸和酰基肉碱含量的差异分析

doi:10.3969/j.issn.1674-490X.2023.06.002

医学研究与教育 ›› 2023, Vol. 40 ›› Issue (6): 12-20.DOI: 10.3969/j.issn.1674-490X.2023.06.002

晚期早产儿血中氨基酸和酰基肉碱含量的差异分析

向晶晶¹,杨冬菲¹,钟小毅¹,王玉²

1.河北大学临床医学院, 河北保定 071000;
2.河北大学附属医院儿科, 河北保定 071000

收稿日期:2023-01-05 出版日期:2023-12-25 发布日期:2023-12-25
通讯作者: 王玉(1981—),女,河北保定人,主任医师,硕士,硕士生导师,主要从事新生儿疾病研究。E-mail: 13785269178@163.com
作者简介:向晶晶(1997—),女,湖南怀化人,医师,在读硕士,主要从事新生儿疾病研究。 E-mail: 13974550292@163.com
基金资助:
河北省医学科学研究课题计划项目(20190938);河北大学医学学科培育项目(2023B05)

Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants

XIANG Jingjing¹, YANG Dongfei¹, ZHONG Xiaoyi¹, WANG Yu²

1.College of Clinical Medicine, Hebei University, Baoding 071000, China; 2.Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding 071000, China

Received:2023-01-05 Online:2023-12-25 Published:2023-12-25

摘要/Abstract

摘要： 目的研究晚期早产儿胎龄、出生体质量及营养支持方式与其血氨基酸和酰基肉碱含量的关系,为该阶段早产儿的营养管理提供针对性的指导。方法选择2017年1月至2021年12月住院的202例晚期早产儿为研究对象,根据胎龄与出生体质量的关系分为适于胎龄儿(appropriate for gestational age,AGA)组、小于胎龄儿(small for gestational age,SGA)组和大于胎龄儿(large for gestational age,LGA)组,根据采样当天的营养支持情况分为完全肠外营养(total parenteral nutrition,TPN)、部分肠外营养(partial parenteral nutrition,PPN)和完全肠内营养(total enteral nutrition,TEN),应用串联质谱技术检测其外周血中氨基酸和酰基肉碱的含量并进行比较。结果 AGA组、SGA组与LGA组间缬氨酸、亮氨酸、甲硫氨酸、苯丙氨酸、酪氨酸、瓜氨酸、脯氨酸含量差异有统计学意义,其中LGA组的氨基酸含量普遍高于AGA组与SGA组。酰基肉碱含量在3组间差异均无统计学意义。TPN、PPN与TEN间甘氨酸、鸟氨酸、亮氨酸、甲硫氨酸、瓜氨酸含量差异均有统计学意义,其中鸟氨酸、亮氨酸、甲硫氨酸、瓜氨酸在TPN方式中相对偏低,而甘氨酸则在TEN中相对偏高。多种短链、长链及小部分中链酰基肉碱含量在不同营养方式中差异有统计学意义,以TEN中相对最高。结论在晚期早产儿中,AGA组、SGA组与LGA组血氨基酸谱存在差异,SGA组在早期可适量补充支链氨基酸、含硫氨基酸及芳香族氨基酸。血氨基酸和酰基肉碱含量易受营养支持方式的影响,应合理调整营养素配比,在肠外营养液中适当提高甘氨酸与肉碱含量,在肠内营养中酌情添加亮氨酸、甲硫氨酸、鸟氨酸及谷氨酰胺。

关键词: 晚期早产儿, 氨基酸, 酰基肉碱, 肠外营养, 肠内营养

Abstract: Objective To study the relationship between gestational age, birth mass and nutritional support modalities of late preterm infants and their blood amino acid and acylcarnitine levels and provide targeted guidance for the nutritional management of preterm infants at this stage of life. Methods 202 late preterm babies hospitalized from January 2017 to December 2021 were selected for the study. According to the relationship between gestational age and body mass at birth, they were divided into appropriate for gestational age(AGA), small for gestational age(SGA)and large for gestational age(LGA)groups. Nutritional support on the day of sampling was categorised as total parenteral nutrition(TPN), partial parenteral nutrition(PPN)and total enteral nutrition(TEN). Determination and comparison of amino acid and acylcarnitine levels in their peripheral blood were conducted by tandem mass spectrometry techniques Results There were statistically significant differences in the levels of valine, leucine, methionine, phenylalanine, tyrosine, citrulline, and proline between the AGA, SGA, and LGA groups, with the levels of these amino acids being generally higher in the LGA than in the AGA and SGA groups. The differences in acylcarnitine levels were not statistically significant among the three groups.The differences in the levels of glycine, ornithine, leucine, methionine, and citrulline between TPN, PPV, and TEN were all statistically significant, with ornithine, leucine, methionine, and citrulline being relatively low in the TPN approach and glycine being relatively high in the TEN approach.The levels of various short-chain, long-chain and some medium-chain acylcarnitines showed statistically significant differences among the different nutritional modalities, with the highest levels in TEN. Conclusion In late preterm infants, there were differences in the blood amino acid profiles of the AGA, SGA and LGA groups, and SGA could be supplemented with branched-chain amino acids, sulphur-containing amino acids and aromatic amino acids in moderation at an early stage. Blood amino acid and acylcarnitine levels are susceptible to nutritional support modalities. Nutrient ratios should be reasonably adjusted to appropriately increase glycine and carnitine levels in parenteral nutrition solutions, and leucine, methionine, ornithine and glutamine should be added as appropriate in enteral nutrition.

Key words: late preterm infants, amino acid, acylcarnitine, extraintestinal nutrition, enteral nutrition

中图分类号:

向晶晶,杨冬菲,钟小毅,王玉. 晚期早产儿血中氨基酸和酰基肉碱含量的差异分析[J]. 医学研究与教育, 2023, 40(6): 12-20.

XIANG Jingjing, YANG Dongfei, ZHONG Xiaoyi, WANG Yu. Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants[J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(6): 12-20.

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晚期早产儿血中氨基酸和酰基肉碱含量的差异分析

Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants

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