EPO联合谷氨酰胺对坏死性小肠结肠炎早产儿胃肠道激素、粪便细菌指标和血清i-FABP、TNF-α、IL-6水平的影响

Effects of EPO Combined with Glutamine on Gastrointestinal Hormones,Fecal Bacteria and Serum i-FABP,TNF-α,IL-6 Levels in Premature Infants with Necrotizing Enterocolitis

目的:探讨促红细胞生成素(EPO)联合谷氨酰胺对坏死性小肠结肠炎(NEC)早产儿胃肠道激素、粪便细菌指标和血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、肠脂肪酸结合蛋白(i-FABP)水平的影响。方法:选取2016年12月~2019年12月期间山东大学附属山东省妇幼保健院及徐州医科大学附属医院NICU收治的NEC早产儿120例,根据随机数字表法将患儿分为E-PO组(EPO治疗)、谷氨酰胺组(谷氨酰胺治疗)、联合组(EPO联合谷氨酰胺治疗),每组各40例。对比三组患儿疗效、胃肠道激素、粪便细菌指标和血清i-FABP、TNF-α、IL-6水平,记录三组不良反应发生率和病死率。结果:联合组的临床总有效率高于谷氨酰胺组、EPO组(P<0.05)。三组治疗后血清TNF-α、IL-6、i-FABP水平均较治疗前下降,且联合组低于谷氨酰胺组、EPO组(P<0.05)。三组治疗后胃泌素(MTL)和胃动素(GAS)水平均较治疗前升高,且联合组高于谷氨酰胺组、EPO组(P<0.05)。三组治疗后细菌总数、杆菌总数、球菌总数均较治疗前升高,且联合组高于谷氨酰胺组、EPO组(P<0.05)。联合组不良反应发生率、病死率均低于谷氨酰胺组、EPO组(P<0.05)。结论:EPO联合谷氨酰胺治疗NEC早产儿,可有效改善胃肠道功能,调节肠道菌群,改善血清炎症因子及i-FABP水平,减少不良反应发生率、病死率,疗效显著。

Objective:To investigate the effects of erythropoietin(EPO)combined with glutamine on gastrointestinal hormones,fecal bacteria and serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and intestinal fatty acid binding protein(i-FABP)levels in premature infants with necrotizing enterocolitis(NEC).Methods:120 cases of NEC premature infants in Shandong Maternal and Child Health Hospital Affiliated to Shandong University and Affiliated Hospital of Xuzhou Medical University from December 2016 to December 2019 were selected,and they were randomly divided into EPO group(EPO treatment),glutamine group(glutamine treatment)and combination group(EPO combined with glutamine treatment),40 cases in each group.The curative effect,gastrointestinal hormones,fecal bacterial indicators and serum i-FABP,TNF-α,IL-6 levels of the three groups were compared,and the incidence rate of adverse reactions and mortality of the three groups were recorded.Results:The total effective rate of the combination group was higher than that of the glutamine group and EPO group(P<0.05).After treatment,the TNF-α,IL-6 and i-FABP levels in the three groups were lower than those before treatment,and those in the combination group were lower than those in the glutamine group and EPO group(P<0.05).After treatment,the gastrin(MTL)and motilin(GAS)levels in the three groups were higher than those before treatment,and those in the combination group were higher than those in the glutamine group and EPO group(P<0.05).After treatment,the total number of bacteria,bacilli and cocci in the three groups were higher than those before treatment,and those in the combination group were higher than those in the glutamine group and EPO group(P<0.05).The incidence rate of adverse reactions and mortality in combination group were lower than those in glutamine group and EPO group(P<0.05).Conclusion:EPO combined with glutamine in the treatment of NEC premature infants can effectively improve gastrointestinal function,regulate intestinal flora,improve serum inflammatory factors and i-FABP levels,reduce the incidence of adverse reactions and case fatality,with a significant efficacy.