深度水解蛋白质配方奶喂养对极低出生体重早产儿早期生长发育的研究

Effect of extensive hydrolyzed protein formula on the early growth of very low birth weight premature infants

目的探讨深度水解蛋白质配方奶(extensively hydrolyzed protein formula,eHPF)对极低出生体重(very low birth weight,VLBW)早产儿肠内营养建立的有效性与安全性。方法选取2015年5月1日至2015年12月31日广州医科大学附属第三医院收治的VLBW早产儿,将其分为eHPF组和早产儿配方奶(premature formula,PF)组,每组各20例。除所用配方奶不同外,两组早产儿均采用类似的喂养方案。监测并比较两组早产儿的肠内喂养进程,生长发育情况及血液生化指标、微量元素、氨基酸和肉碱浓度。结果出生后第14天,eHPF组早产儿奶量显著高于PF组(P=0.017)。eHPF组早产儿在新生儿期内达到全肠内喂养的比例显著高于PF组(P=0.038)。出生后第7天、第14天、第21天、第28天和出院时,两组早产儿的体重、身长、头围和生长迟缓发生率比较均无统计学意义(均P>0.05)。出生后第28天,两组早产儿血液中总蛋白、白蛋白、尿素氮、肌酐、胆固醇、甘油三酯、磷酸盐、钙、铁、镁、锌、锰、铜、23种氨基酸和26种肉碱浓度比较均无统计学意义(均P>0.05)。结论eHPF喂养可加速VLBW早产儿肠内营养的建立,且对新生儿期VLBW早产儿生长发育和营养状况无不利影响。

Objective To explore the effectiveness and safety of extensively hydrolyzed protein formula(eHPF)in very low birth weight(VLBW)enteral nutrition to establish the validity of premature babies.Method Premature infants with VLBW admitted to the Third Affiliated Hospital of Guangzhou Medical University from May 1st,2015 to December 31th,2015 were divided into eHPF group and premature formula(PF)group,with 20 cases in each group.The two groups of preterm infants were fed a similar regimen,except with different formulas.The growth and blood biochemical indicators,trace elements,amino acids,carnitine concentrations of preterm infants in the two groups were monitored and compared.Result On the 14th day after birth,the total milk volume of premature infants in eHPF group was significantly higher than that in PF group(P=0.017).The proportion of preterm infants in eHPF group achieving whole-intestinal feeding during the neonatal period was significantly higher than that in PF group(P=0.038).On the 7th,14th,21st,28th after birth and discharge day,there were no statistically significant differences in body weight,body length,head circumference and growth retardation between the two groups(all P>0.05).On 28 days after birth,the blood concentrations of total protein,albumin,urea nitrogen,creatinine,cholesterol,triglyceride,phosphate,calcium,iron,magnesium,zinc,manganese,copper,23 kinds of amino acids and 26 kinds of carnitine in the two groups of premature infants had no statistical significance(all P>0.05).Conclusion eHPF feeding could accelerate the establishment of enteral nutrition in VLBW premature infants,and has no significant adverse effect on the growth and nutritional status of VLBW preterm infants.