Clinical high-risk factors of metabolic bone disease in very low birth weight infants

Q4 Nursing 中华临床营养杂志 Pub Date : 2019-12-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.06.008

Jiaxin Xu, Lin Xianghong, Xiaohu Wang, Xian-hong Yin, Hongmin Xi, Rui Yuan

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Abstract

Objective To explore the high-risk factors of metabolic bone disease(MBD)in premature infants by retrospective analysis of the clinical data so as to provide evidence for optimal clinical management. Methods Clinical data of premature infants with birth weight 500 IU/L and blood phosphorus <1.5 mmol/L were selected as MBD group and premature infants with birth weight <1 500 g were selected randomly as non-MBD group. General data, pulmonary surfactant, continuous positive airway pressure, mechanical ventilation, start time of enteral nutrition, parenteral nutrition (PN) time, breast feeding time and breast milk fortifier adding, drug usage, hospitalization time and complications were recorded and compared between the two groups. Results A total of 440 premature infants with birth weight <1 500 g were admitted to the hospital during the study period. 58[13.2%(58/440)] infants were enrolled in the MBD group, among which infants with birth weight <1 000 g accounting for 56.9%(33/58). High birth weight (OR=0.62, 95% CI: 0.389-0.990) was an independent protective factor of MBD in premature infants. The higher the birth weight, the lower the risk of MBD in premature infants. The longer duration of breast feeding time(OR= 2.191, 95% CI: 1.628-2.950), later initial time of enteral feeding(OR=2.695, 95% CI: 1.710-4.248), longer duration of PN(OR=6.205, 95% CI: 3.359-11.463) time, longer duration of respiratory supporting time(OR=1.046, 95% CI: 1.026-.067), longer hospital stay time(OR=1.703, 95% CI: 1.109-2.615) and small for gestational age(OR=2.965, 95% CI: 1.163-5.658) were independent risk factors of MBD in premature infants. The duration of PN was the most important independent risk factor of MBD in premature infants(OR=6.205, 95% CI: 3.359-11.463). Conclusion Multiple factors can lead to MBD of premature infants. The high birth weight is an independent protective factor of MBD and the duration of PN is the most important independent risk factor of MBD in premature infants. Key words: Premature infant; Metabolic bone disease; High risk factor

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极低出生体重儿代谢性骨病的临床高危因素

目的通过对临床资料的回顾性分析，探讨早产儿代谢性骨病（MBD）的高危因素，为临床优化管理提供依据。方法选择出生体重500IU/L、血磷<1.5mmol/L的早产儿作为MBD组，随机选择出生体重<1500g的早产儿作为非MBD组。记录并比较两组的一般数据、肺表面活性物质、持续气道正压、机械通气、肠内营养开始时间、肠外营养（PN）时间、母乳喂养时间和添加母乳强化剂、用药情况、住院时间和并发症。结果在研究期间，共有440名出生体重<1 500 g的早产儿入院。58名[13.2%（58/440）]婴儿被纳入MBD组，其中出生体重<1000g的婴儿占56.9%（33/58）。高出生体重（OR=0.62，95%CI:0.389-0.990）是早产儿MBD的独立保护因素。出生体重越高，早产儿患MBD的风险就越低。母乳喂养时间较长（OR=2.191，95%CI:1.628-2.950），肠内喂养初始时间较晚（OR=2.695，95%CI:1.710-4.248），PN持续时间较长（OR=6.255，95%CI:3.359-11.463），呼吸支持时间较长（OR=1.046，95%CI:1.026-.067），住院时间较长（OR=1.703，95%CI:1.109-2.615）和胎龄较小（OR=2.965，95%CI:11.163-5.658）是早产儿MBD的独立危险因素。PN持续时间是早产儿MBD最重要的独立危险因素（OR=6.205，95%CI:3.359-11.463）。高出生体重是MBD的独立保护因素，PN持续时间是早产儿MBD最重要的独立危险因素。关键词：早产儿；代谢性骨病；高风险因素

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.