中文摘要：

目的观察NICU中不同胎龄低出生体质量儿血生化指标，探讨临床早期评估低出生体质量儿营养状况的敏感指标。方法采用前瞻性研究方法观察不同胎龄低出生体质量儿[胎龄28～31周（G28-31）组、胎龄32～36周（G32-36）组和胎龄37．42周（G37-42）组]在新生儿期第1天和肠内营养达到推荐摄入标准（RDIs）后第1天血清清蛋白（ALB）、血糖（Glu）、总胆固醇（Tc）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）水平变化。结果在新生儿期第1天，胎龄越小，血ALB水平越低，3组ALB水平比较差异有统计学意义（P〈0．05）。G37-42组在新生儿期第1天TC、LDL-C、ApoB明显低于G28-31组和G32-36组，而在肠内营养达到RDIs后第1天，其TG、LDL-C、ApoB上升趋势明显高于G28-31组和G32-36组，差异均有统计学意义。结论血ALB是临床早期评估不同胎龄低出生体质量儿营养状况的敏感指标之一，定期监测血脂中LDL-C、ApoB水平变化，可为新生儿早期营养干预提供合理指导，避免在追赶式生长过程中不适当地补充营养，导致代谢紊乱，产生远期不良后果。

英文摘要：

Objective To investigate the early assessment index of nutrition of low birth weight newborns with different gestational age in neonatal intensive care unit. Methods Prospective study was carried in low birth weight newborns divided by different gestational age [ gesta- tional age 28 -31 weeks （G28 -31 ） group, gestational age 32 -36 weeks （G32 -36） group and gestational age 37 -42 weeks （G37 -42 ） group ]. Serum index including serum albumin （ ALB ）, glucose （ Glu）, total cholesterol （ TC ）, triglyceride （ TG）, high density lipoprotein cholesterol （ HDL - C ） ,low density lipoprotein cholesterol （ LDL - C ）, apolipoprotein A （ ApoA）, apolipoprotein B （ ApoB ） were tested at the first day and enteral nutrition reached to recommended diet intakes（RDIs）. Results Serum ALB increased obviously according to gesta- tional age （ P 〈 0. 05 ）. TC, LDL - C, ApoB levels in newborn infants in the first day in G37 - 42 group were significantly lower than those in G28 -31 group and G32 -36 group, whereas at the first day after enteral nutrition to RDIs, their TG, LDL - C, ApoB levels increased signifi- cantly higher than those in the G28 -31 group and G32 -36 group, there were statistical differences. Conclusions Blood ALB is early clini- cal sensitive indicators for evaluating nutritional status of low birth weight infants with different gestational age, regularly monitoring blood lip- ids in LDL - C, ApoB level changes, can provide reasonable guidance for the early neonatal nutritional intervention, avoid chasing growth process without proper nutrition lead to metabolic disorders.