个性化免疫强化对早产致低出生体重儿营养支持的影响

Effect of personalized immune enhancement on nutritional support of low birth weight infants caused by preterm birth

目的了解免疫强化对因早产所致低出生体重儿营养支持的临床疗效,为新生儿营养保健提供理论依据。方法选取2015年1月-2016年9月在该院出生并住院治疗的172例早产所致低出生体重儿进行临床对照试验,根据性别、体重进行匹配分为对照组和试验组,每组各86例。对照组采取肠内营养加静脉支持的营养方式,实验组采取同样的肠内营养,结合个性化的免疫强化进行营养支持。比较两组新生儿出生后第1周和第2周体重、体重增长速率、总热能摄入量、前白蛋白(PA)、白蛋白(ALB)、尿素氮(Urea)的差异,并比较两组新生儿住院期间营养相关并发症发生率的差异。结果两组早产儿出生后体重、体重增长速率、总热能摄入量、PA、ALB、Urea进行重复测量方差分析发现,3项指标前后比较差异均有统计学意义(均P<0.05);分析该差异的具体来源,均由组间差异、时间因素、组间和时间相互作用构成;两组早产儿出生后第1周、第2周体重、体重增长速率、总热能摄入量、PA含量、ALB含量、Urea含量比较差异均有统计学意义(均P<0.05);两组早产儿住院期间低血糖症和贫血发生率显著均高于对照组(均P<0.05)。结论因早产所致低出生体重儿在临床营养支持过程中,除常规肠内营养和静脉营养支持外,根据新生儿营养状况给予个性化的免疫强化有助于新生儿基础能量摄入的增加和体重的恢复,降低营养相关并发症的发生率。

Objective To investigate the clinical effect of immune enhancement in nutritional support of low birth weight infants caused by preterm birth,and provide a theoretical basis for neonatal nutrition health care. Methods A total of 172 low birth weight infants caused by preterm birth who were born and treated in the First People＇s Hospital of Tianmen from January 2015 to September 2016 were selected for a clinical case-control study. All the infants were divided into control group and experimental group according to gender and weight,86 infants in each group. The infants in control group were treated by enteral nutrition combined with parenteral nutrition,and the infants in experimental group were treated by enteral nutrition combined with personalized immune enhancement. The indexes were compared between the two groups at one and two weeks after birth,including weight,the rate of weight gain,the total intake of heat energy,prealbumin（ PA）,albumin（ ALB）,and urea nitrogen（ Urea）. The incidence rates of nutrition-related complications in hospital were compared between the two groups. Results There were statistically significant differences in weight,the rate of weight gain,the total intake of heat energy,PA,ALB,and Urea between the two groups（ P〈0. 05）. The differences were composed of difference between groups,time factor,interaction of inter-group factor and time factor. There were statistically significant differences in weight,the rate of weight gain,the total intake of heat energy,PA,ALB,and Urea at one and two weeks after birth between the two groups（ P〈0. 05）. The incidence rates of hypoglycemia and anemia in experimental group were statistically significantly higher than those in control group（ P〈0. 05）. Conclusion In addition to conventional enteral nutrition and intravenous nutritional support,individualized immune enhancement according to neonatal nutritional status can increase basic energy intake and recovery of neonatal weight and reduce the incidence rates of nutrition-related complications in the course of clinical nutritional support among low birth weight infants due to premature birth.