【摘要】 目的对极低出生体重儿(VLBWI)的早期营养与生后头围生长、MRI影像学的关系进行探讨。方法将57例VLBWI随机分为高静脉营养(干预组)27例和标准静脉营养(对照组)30例,两组均联合肠道喂养,监测生长状况、记录热卡蛋白质摄入量至纠正胎龄40周;纠正胎龄40周时,记录头围、身长与体重,用MRI测量总脑容积(TBV)、皮层脑容积(CBV)及T2驰张时间,并进行统计分析。结果在纠正胎龄40周时,干预组各生长指标(头围、身长及体重)均高于对照组,干预组MRI T2值低于对照组,均有统计学意义;能量摄入多寡与TBV呈正相关性(r=0.35,P<0.05),T2值与TBV呈负相关(r=-0.33,P<0.05)。结论尽早喂养及积极充分地使用胃肠外营养,能促进脑组织增长及成熟。MRI T2值对脑发育有很好的参考价值。更多还原

【Abstract】 Objective To analyze the relationship between earlier macronutrients in very low birth weight infants(VLBWI) and postnatal head growth and the data from quantitative magnetic resonance imaging(MRI).Methods Fifty-seven VLBWI were randomized to hyperalimented(intervention group),standard parenteral(control group),and enteral nutrition.27 infants in the intervention group and 30 infants in the control group.Head circumference was measured and quantitative was performed at CGA 40 weeks.Results Energy and protein intake of the intervention group were significantly higher than that of the control group.There was statistically significant difference between the two groups in the primary growth variables at CGA 40 weeks(P<0.05).Energy intake was positively correlated with TBV(r=0.35,P<0.05).T2 values was negatively correlated with TBV(r=-0.33,P<0.05).Conclusion MRI T2 relaxation times are predictive of head growth;earlier enteral feeding and hyperalimented nutrition could promote brain growth and maturation.更多还原