目的探讨早产小于胎龄儿(SGA)与适于胎龄儿(AGA)住院期间生长代谢的差异。方法回顾性分析我院2008年1月至2012年12月收治的胎龄28~34周早产儿病例,根据胎龄与出生体重的关系分为SGA组与AGA组,比较两组早产儿一般情况、体格增长、血生化指标及合并症等。结果纳入研究的早产儿共164例,SGA组78例,AGA组86例。2组早产儿入院胎龄、性别、发生呼吸窘迫综合征的比例、恢复出生体重日龄等差异均无统计学意义(P>0.05)。SGA组与AGA组相比,窒息比例高(25.6%比12.8%),住院时间长[36.5(28,45.5)天比28(22,36)天],肠外营养时间长[26(19,35)天比22(16,30)天],差异有统计学意义(P<0.05)。恢复出生体重后,SGA组与AGA组相比平均每日体重增长速率快[(20.6±3.3)g/(kg·d)比(18.4±3.8)g/(kg·d)],每周头围增长速度快[(0.71±0.25)cm比(0.55±0.26)cm],差异有统计学意义(P<0.05),每周身长增长速度差异无统计学意义(P>0.05)。SGA组前白蛋白低于AGA组,胆汁酸高于AGA组,败血症和慢性肺疾病发生率均高于AGA组(20.5%比9.3%,11.5%比1.2%),差异均有统计学意义(P<0.05),早产儿视网膜病和坏死性小肠结肠炎发生率差异无统计学意义(P>0.05)。结论 SGA早产儿恢复出生体重后生长速率及头围增长速度快于AGA早产儿,但身长增长速度无差异;SGA早产儿出生及出院时血前白蛋白水平均低于AGA早产儿;SGA早产儿更易发生胆汁淤积、败血症及慢性肺疾病。 Objective To investigate the differences in the growth and metabolism between preterm infants with gestational age (SGA) and gestational age (AGA) during hospitalization. Methods A retrospective analysis of our hospital from January 2008 to December 2012 were admitted to gestational age 28 to 34 weeks of premature children cases, according to gestational age and birth weight was divided into SGA group and AGA group, compared the general situation of the two groups of preterm children , Physical growth, blood biochemical indicators and complications. Results A total of 164 preterm infants were included in the study, 78 in the SGA group and 86 in the AGA group. There were no significant differences in the gestational age, gender, respiratory distress syndrome, and birth weight at birth between the two groups (P> 0.05). SGA had a higher rate of asphyxia (25.6% vs 12.8%), length of hospital stay (36.5 (28.45.5) days vs 28 (22.36) days), prolonged parenteral nutrition (26, 19, 35) than the days of 22 (16,30) days, the difference was statistically significant (P <0.05). After resuming birth weight, the average daily rate of weight gain in SGA group was significantly faster than that in AGA group [(20.6 ± 3.3) g / (kg · d) vs (18.4 ± 3.8) g / (kg · d)], (0.71 ± 0.25) cm (0.55 ± 0.26) cm, the difference was statistically significant (P <0.05). There was no significant difference in the rate of body length growth per week (P> 0.05). Pre-albumin in SGA group was lower than that in AGA group, bile acid was higher than that in AGA group, sepsis and chronic lung disease were higher than AGA group (20.5% vs 9.3%, 11.5% vs 1.2%), the difference was statistically significant P <0.05). There was no significant difference in the incidence of retinopathy of prematurity and necrotizing enterocolitis (P> 0.05). CONCLUSIONS: The growth rate and head circumference of preterm infants with SGA are faster than that of AGA premature infants, but the growth rate of SGA is no different. The prealbumin levels in preterm infants with SGA are lower than premature infants with AGA More prone to cholestasis, sepsis and chronic lung disease.