双歧杆菌对极低体质量婴儿免疫功能的调节作用及对婴儿开奶时间的影响

Effect of Bifidobacteria on immune function and the first milk-feeding time in very low weight infants

目的观察双歧杆菌对极低体质量婴儿免疫功能的调节作用及对婴儿开奶时间的影响。方法选取2017年1月至2018年12月东南大学附属中大医院江北院区诊治的极低体质量婴儿160例为研究对象。完全随机分为对照组和观察组,各80例。对照组给予常规的综合治疗,观察组在对照组的基础上给予双歧杆菌治疗,分析2组婴儿坏死性小肠结肠炎(NEC)的发生情况,分析双歧杆菌对2组婴儿免疫功能的调节作用及对开奶时间的影响。结果观察组重度、中度和轻度NEC及总发生率明显低于对照组,婴儿的死亡率明显低于对照组,差异均有统计学意义(均P<0.05)。观察组患儿的初次排便时间、胎粪排尽时间、大便次数、恢复出生体质量时间及开奶时间[(26±3)h比(37±4)h]均明显短于/少于对照组,差异均有统计学意义(均P<0.05)。治疗后2组CD3^+、CD4^+和CD4^+/CD8^+比值均明显升高,且观察组高于对照组[(54.5±5.3)%比(52.6±4.8)%、(37.5±4.6)%比(33.6±4.3)%、(2.8±0.5)比(2.1±0.4)];而CD+8水平明显降低,且观察组低于对照组[(13.6±2.6)%比(15.8±3.4)%],差异均有统计学意义(均P<0.05)。结论双歧杆菌对极低体质量婴儿免疫功能有显著的改善作用,且可缩短开奶时间。

Objective To observe the effect of Bifidobacteria on immune function and the first milk-feeding time in very low weight infants.Methods A total of 160 very low weight infants were enrolled from January 2017 to December 2018 in Zhongda Hospital Affiliated to Southeast University(Jiangbei).All infants were randomly divided into control group and observation group,with 80 cases in each group.The control group were treated with routine comprehensive treatments;the observation group was treated with Bifidobacteria on the basis of routine treatments.Incidence of necrotizing enterocolitis(NEC),immune function indexes and the first milk-feeding time were analyzed.Results Incidences of severe,moderate,mild NEC and the mortality rate in observation group were significantly lower than those in control group(all P<0.05).The first defecation time,meconium exhaustion time,frequency of defecation,birth weight recovery time and the first milk-feeding time[(26±3)h vs(37±4)h]in observation group were significantly shorter/less than those in control group(all P<0.05).After treatment,CD3^+,CD4^+and CD4^+/CD8^+significantly increased in both groups and the levels in observation group were higher than those in control group[(54.5±5.3)%vs(52.6±4.8)%,(37.5±4.6)%vs(33.6±4.3)%,(2.8±0.5)vs(2.1±0.4)];CD+8 decreased significantly and it was lower in observation group than that in control group[(13.6±2.6)%vs(15.8±3.4)%](all P<0.05).Conclusion Bifidobacteria can significantly improve the immune function of very low birth weight infants and shorten the first milk-feeding time.