目的：探讨新生黄疸患儿与早产低体质量儿体内氨基酸水平变化并分析其原因。方法利用串联质谱技术（TMS）采用衍生法检测干血滤纸片中18种氨基酸水平。通过t检验统计比较原血片、召回血片两次氨基酸的水平，分析新生儿干血滤纸片中氨基酸水平变化的原因。结果（1）新生黄疸患儿共38例，除天冬氨酸（Asp）、瓜氨酸（Cit）两种氨基酸外，共有丙氨酸（Ala）、谷氨酸（Glu）、蛋氨酸（Met）、苯丙氨酸（Phe）、酪氨酸（Tyr）、亮氨酸（Leu）、色氨酸（Trp）、缬氨酸（Val）、甘氨酸（Gly）、鸟氨酸（Orn）、组氨酸（His）、丝氨酸（Sern）、苏氨酸（Thr）、脯氨酸（Pro）14种氨基酸检测结果，召回血片较原血片明显降低（P＜0．05）；谷氨酰胺（Gln）、精氨酸（Arg）共2种氨基酸检测结果，召回血片较原血片明显升高（P＜0．05）。（2）早产低体质量儿共46例，除Glu、Cit、Gln、His4种氨基酸外，Ala、Asp、Met、Phe、Tyr、Leu、Trp、Val、Arg、Gly、Orn、Sern、Thr、Pro共14种氨基酸检测结果，召回血片较原血片明显降低（P＜0．05）。结论新生儿黄疸及早产低体质量时期严重影响了干血滤纸片多种氨基酸水平的变化，故实验室对氨基酸遗传代谢病筛查结果的判断应结合新生儿病史，排除假阳性，从而减轻新生儿筛查工作者的压力及家长的精神负担。%Objective To discuss and analyze the change and causes of amino acid level in jaundice neonates and premature low-birth-weight neonates .Methods By utilizing the tandem mass spectrometry(TMS) ,the derivative method was adopted to measure 18 kinds of amino acid in dried blood spot (DBS) .The amino acid levels were com-pared between the initial DBS and the recalled DBS by t-test .The causes of amino acid concentration variation in neo-natal dried blood spot were analyzed .Results (1)In 38 jaundice neonates ,except Asp and Cit ,the concentrations of Ala ,Glu ,Met ,Phe ,Tyr ,Leu ,Trp ,Val ,Gly ,Orn ,His ,Sern ,Thr and Pro in the recalled DBS were significant de-creased compared with the initial DBS (P<0 .05) ,while the concentrations of Gln and Arg in the recalled DBS were significant increased compared with the initial DBS (P<0 .05) .(2)In 48 low-birth-weight neonates ,except Glu ,Cit , Gln and His ,the concentrations of other amino acids in the recalled DBS were significant decreased compared with the initial DBS(P<0 .05) .Conclusion Neonatal jaundice and premature low-birth-weight seriously affect the change of amino acid levels in DBS .So the laboratory judgement on the screening results of amino acid genetic metabolic disea-ses should combine with the neonatal history and exclude the false positive ,thus alleviate the pressure of neonatal screening workers and mental burden of parents .
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