母乳联合妈咪爱对极低出生体重儿炎性细胞因子的影响

The effect of breast milk combined with Medilac-Vita on serum inflammatory cytokines in extremely low birth weight infants

目的探讨母乳联合妈咪爱对极低出生体重儿(ELBWI)炎性细胞因子的影响。方法采用前瞻性研究法,选择2012年2月至2016年5月在我院诊治的ELBWI 76例,根据随机数字表法分为观察组与对照组各38例,对照组给予母乳喂养,观察组给予母乳联合妈咪爱喂养,两组均给予暖箱保暖、治疗原发病等对症治疗。治疗14 d后,观察两组患儿的预后与炎性细胞因子表达情况。结果观察组与对照组的喂养不耐受率分别为7.9%和26.3%,观察组明显少于对照组(x^2=3.289,P<o.05)。对照组的头围、身长、体重增长速度分别为(0.59±0.19)cm/周、(0.75±0.10)cm/周、(13.47±3.35)g/d,都明显少于观察组的(0.66±0.13)cm/周、(0.83±0.09)cm/周、(16.31±3.72)g/d。治疗后观察组的CD4^+细胞值明显高于治疗前,而CD8^+细胞值明显低于治疗前,且与对照组对比差异有统计学意义(P<0.05),而对照组治疗前后的CD4^+、CD8^+细胞值对比差异无统计学意义(P>0.05)。观察组治疗后的血清IL-6与TNF-α含量分别为(16.33±11.61)ng/L和(25.23±8.92)ng/L,均明显低于对照组的(26.35±11.56)ng/L与(33.72±10.36)ng/L(P<0.05),且都明显低于治疗前(P<0.05)。结论母乳联合妈咪爱喂养可改善ELBWI早期喂养的耐受性,提高患儿免疫功能,降低炎性细胞因子IL-6与TNF-a的表达,从而对生长发育有一定促进作用。

Objective To explore the effect of breast milk combined with Medilac-Vita on serum inflammatory cytokines in extremely low birth weight（ELBW） infants.Methods A prospective study method was used.76 ELBW infants in our hospital from February 2012 to May 2016 were enrolled and randomly divided into the observation group or control group（38 cases in each group）.The control group was given breast milk feeding,while the observation group was given breast milk combined with Medilac-Vita feeding;all the infants were given supportive treatment with infant incubator and other symptomatic treatment of primary disease.After treated for 14 days,the prognoses and levels of inflammatory cytokines of the infants were analyzed.Results The rate of feeding intolerance was 7.9%in the observation group vs 26.3%in the control group,with significant difference（x^2 = 3.289,P〈0.05）.The growth rates of head circumference,body height and body weight in the control group were significantly lower than those in the observation group[（0.59 ± 0.19） vs（0.66 ± 0.13） cm/week,（0.75 ± 0.10） vs（0.83 ± 0.09） cm/week and（13.47 ± 3.35）vs（16.31 ± 3.72） g/day respectively（P〈0.05）].After treatment,the level of CD4~＋ T cells was significantly higher while that of CD8~＋ T cells significantly lower in the observation group than before treatment,and was significantly different from that of the control group,respectively（P〈0.05）;such significant changes were not observed in the control group（P〈0.05）.The levels of serum IL-6 and TNF-α in the observation group after treatment were significantly lower than those before the treatment（P〈0.05）,and significantly lower than those in the control group（P〈0.05）.Conclusion Breast milk combined with Medilac-Vita can improve the tolerance of ELBW infants to early feeding and their immune function,reduce the expression of inflammatory cytokines IL-6 and TNF-a,thus promote the growth and development of infants.