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SGA 早产儿 [3] 。研究表明,生长是预先设定在某个阶
段或时期发生的,早产儿在出院后至矫正年龄 2~3 月龄
内存在一个生长发育的“机会窗”,如果错过关键时期,
可能无法弥补,即使短期的生长受限也可能影响早产儿
的身体健康,甚至影响其大脑的生长和发育 [6-7] 。掌握
这些关键期,可以帮助早产儿更好地进行生长追赶。极
早产儿的生长速率明显慢于足月儿,SGA 极早产儿更是
落后,需要高度重视极早产儿的早期追赶生长。建立科
学的早产儿管理制度、定期监测早产儿体格生长指标、
为每个早产儿量身制订合适的追赶方案、科学合理喂养、
实施有效干预措施等,对促进早产儿体格指标达到适宜
的追赶生长具有极高的临床意义及社会价值。
注:SGA= 小于胎龄儿,AGA= 适于胎龄儿
图 1 三组各月龄体质量 Z 评分追赶趋势
Figure 1 The trend of catch-up growth for body weight z-score among
three groups at different months of corrected age
图 2 三组各月龄身长 Z 评分追赶趋势 图 3 三组各月龄头围 Z 评分追赶趋势
Figure 2 The trend of catch-up growth for body length z-score among Figure 3 The trend of catch-up growth for head circumference z-score
three groups at different months of corrected age among three groups at different months of corrected age
表 2 三组体格生长速率比较﹝ M(P 25 ,P 75 )﹞
Table 2 Comparison of growth rates assessed by body weight,body lengthand head circumference among three groups
SGA 极早产儿组 AGA 极早产儿组 足月儿组
体格指标 矫正月龄 H 值 P 值
(n=11) (n=109) (n=121)
体质量 40 周 ~3 个月 0.073(-0.026,0.180) 0.148(0.014,0.232) 0.030(-0.049,0.163) 6.530 0.038
3~6 个月 0.149(0.095,0.227) 0.057(0.002,0.113) 0.008(-0.072,0.101) 12.954 0.002
6~12 个月 0.086(0.030,0.140) 0.024(-0.008,0.054) 0.001(-0.015,0.025) 13.834 0.001
12~24 个月 0.012(-0.004,0.027) 0.007(-0.013,0.031) -0.002(-0.022,0.020) 0.934 0.627
24~36 个月 0.030(-0.007,0.051) 0.025(-0.011,0.049) 0.015(-0.007,0.041) 1.045 0.593
身长 40 周 ~3 个月 0.073(0.028,0.126) 0.088(-0.029,0.196) 0.021(-0.023,0.076) 6.661 0.036
3~6 个月 0.209(0.171,0.242) 0.083(0.060,0.119) 0.088(-0.007,0.194) 17.462 <0.001
6~12 个月 0.085(0.069,0.105) 0.037(0.008,0.061) -0.018(-0.051,0.029) 21.428 <0.001
12~24 个月 0.019(0.001,0.046) 0.001(-0.011,0.013) -0.015(-0.027,0.002) 16.806 <0.001
24~36 个月 0.008(0.002,0.015) 0(-0.017,0.015) 0.007(-0.003,0.025) 1.870 0.393
头围 40 周 ~3 个月 0.007(-0.053,0.105) 0.065(0.021,0.109) 0(-0.028,0.053) 8.626 0.013
3~6 个月 0.107(0.051,0.179) 0.047(0.026,0.077) 0.027(0,0.077) 6.195 0.045
6~12 个月 0.098(0.051,0.154) 0.078(0.051,0.103) -0.005(-0.013,0.013) 26.006 <0.001
12~24 月 0.031(0.006,0.058) 0.025(0.013,0.045) 0.002(-0.006,0.013) 11.971 0.003
24~36 个月 0.002(-0.013,0.013) 0.002(-0.013,0.013) 0.003(-0.013,0.019) 0.164 0.921
注:生长速率 =(后一年龄数据 - 前一年龄数据)/ 两个年龄点间隔时间(月)