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目的探讨骨定量超声技术(QUS)在评价早产儿骨量中的应用以及影响早产儿骨发育的因素。方法对2008年5月至2009年11月本院新生儿病房收治、<7天的早产儿采用QUS、选择左小腿胫骨中1/3段内侧面测量声波传导速度(SOS),同时通过问卷调查的形式,对新生儿性别、胎龄、出生体重及母孕期钙营养状况、居住状况、有无疾病、不良嗜好等进行调查,分析各因素对早产儿骨发育的影响。结果体重≤1500g、1501～2000g和2001～2500g早产儿SOS值分别为(2501±70)m/s、(2624±89)m/s和(2768±211)m/s,体重越大,SOS值越高,差异有统计学意义(P均<0.05)。不同性别早产儿SOS值差异无统计学意义(P>0.05)。体重≤1500g的早产儿血钙(mmol/L)、血磷(mmol/L)和碱性磷酸酶(U/L)均低于2001～2500g的早产儿[血钙:(1.98±0.12)比(2.10±0.17),血磷:(1.53±0.21)比(1.92±0.28),碱性磷酸酶:(196±38)比(201±19),P均<0.05]。孕期每日摄入牛奶>200ml的母亲所生早产儿SOS值为(2788±95)m/s,不喝牛奶组孕母所生早产儿SOS值为(2659±121)m/s,差异有统计学意义(P<0.05)。结论早产儿出生体重越低,SOS值、血钙、血磷和碱性磷酸酶越低;孕期母亲每日摄入牛奶有利于早产儿骨骼发育;QUS可用于早产儿骨量的评价。
Objective To investigate the application of bone quantitative ultrasound (QUS) in the evaluation of bone mass in preterm infants and the factors influencing bone development in preterm infants. Methods From May 2008 to November 2009, our hospital neonatal ward was treated. QUS was used in preterm infants less than 7 days. Sonic wave velocity (SOS) was measured in medial aspect of 1/3 of the left tibia. At the same time, Of the form of neonatal gender, gestational age, birth weight and calcium status during pregnancy, living conditions, with or without disease, bad habits were investigated to analyze the impact of various factors on bone development in preterm infants. Results The SOS values of body weight ≤ 1500g, 1501 ~ 2000g and 2001 ~ 2500g preterm infants were (2501 ± 70) m / s, (2624 ± 89) m / s and 2768 ± 211 m / The higher the value, the difference was statistically significant (P <0.05). There was no significant difference in SOS between different sexes (P> 0.05). Serum calcium (mmol / L), serum phosphate (P <0.01) and alkaline phosphatase (U / L) in preterm infants with body weight ≤ 1500g were lower than those in premen (2.10 ± 0.17), serum phosphorus (1.53 ± 0.21) vs (1.92 ± 0.28), alkaline phosphatase (196 ± 38), (201 ± 19), P all <0.05. The SOS value of preterm infants born to mothers with> 200ml of milk during pregnancy was (2788 ± 95) m / s, and that of premature infants born without milk was (2659 ± 121) m / s, with a difference of Statistical significance (P <0.05). Conclusions The lower the birth weight, the lower the SOS value, serum calcium, phosphorus and alkaline phosphatase in preterm infants. The daily intake of milk during pregnancy is beneficial to the bone development in premature infants. QUS can be used to evaluate the bone mass in premature infants.