付仕强　陈伟明　于利　何春

[摘要] 目的 探讨早期综合干预对早产低体重儿出生后早期追赶生长及胰岛素敏感性的影响。 方法 回顾性分析2014年4月～2015年12月于我院儿科收治住院的100例早产低体重儿的住院资料，将其分为实验组和对照组，其中对照组早产低体重儿48例，住院时间为2014年4月～2015年1月，该组早产低体重儿接受常规育儿干预；实验组早产低体重儿52例，住院时间为2015年2～12月，该组早产低体重儿接受早期综合干预。观察并比较两组早产低体重儿3个月时的胰岛素敏感性及头围、体重、身长的追赶生长情况。 结果 实验组早产低体重儿3个月时的头围、体重、身长的追赶生长比例均显著高于对照组（P<0.05）。实验组早产低体重儿3个月时的血胰岛素水平及其内稳态模式评估值（HOMA）显著低于对照组早产低体重儿（P<0.05）。 结论 采用早期综合干预模式对早产低体重儿进行干预可以有效促进早产低体重儿胃肠功能发育成熟，提高其胰岛素敏感性，并促进早产低体重儿追赶生长，临床上值得进行推广。

[关键词] 早期综合干预；早期追赶生长；胰岛素敏感性

[中图分类号] R722 [文献标识码] A [文章编号] 1674-4721（2016）02（c）-0195-03

[Abstract] Objective To explore and analyze the impact of early comprehensive intervention on early catch-up growth and insulin sensitivity in preterm low birth weight （PLBW） infants. Methods From April 2014 to December 2015，hospitalized data from 100 PLBW infants admitted into our pediatric department were retrospectively analyzed.They were divided into experimental group and control group.In the control group （n=48），PLBW infants hospitalized from April 2014 to January 2015 were treated by conventional child rearing intervention.In the experimental group （n=52），PLBW infants hospitalized from February 2015 to December were provided with early comprehensive intervention.The insulin sensitivity，and catch-up growth conditions including head circumference，weight，and height were observed and compared in both groups 3-month after birth. Results In the experimental group，3-month after birth，The proportions of catch-up growth conditions including head circumference，weight，and height in these infants were much higher than those of control group （P<0.05）.The blood insulin level and homeostasis model assessment （HOMA） value in the experimental group during third month after birth were greatly lower in comparison with than those of control group （P<0.05）. Conclusion Application of early comprehensive intervention mode on PLBW infants can effectively promote maturation of gastrointestinal function and increase the insulin sensitivity.Early comprehensive intervention can boost up catch-up growth in preterm children and is worthy of clinical promotion.

[Key words] Early comprehensive intervention；Early catch-up growth；Insulin sensitivity

胎儿宫内生长受限往往会导致胎儿早产，此时娩出胎儿被称作小于胎龄儿或早产低体重儿[1]。近年来，随着医疗卫生条件的改善，早产低体重儿的存活率逐年上升[2]，由于宫内生长受限，早产低体重儿的生长发育情况均劣于足月儿，其各器官系统发育均不成熟，易发生新生儿缺血缺氧性脑病、窒息等问题[3]，早产低体重儿在其出生后1年中会发生追赶生长的现象，因此促进早产低体重儿的追赶生长至关重要[4]。研究表明，早产低体重儿出生后早期追赶生长与其胰岛素敏感性密切相关[5]。我院近来研究发现采用早期综合干预模式对早产低体重儿进行干预具有较好的临床疗效，现报道如下。……