口服益生菌联合茵栀黄口服液治疗新生儿高胆红素血症的效果及免疫机制分析

Analysis of the efficacy and immune mechanism of oral probiotics combined with Yinzhihuang oral liquid on neonates with hyperbilirubinemia

目的观察口服益生菌联合茵栀黄口服液治疗新生儿高胆红素血症的效果及其对患儿免疫系统的影响。方法选取2016年5月至2021年8月于西安医学院第二附属医院就诊的高胆红素血症新生儿为研究对象248例,采用随机数字表法分为对照组和观察组,各124例。对照组给予茵栀黄口服液治疗;观察组在对照组治疗的基础上口服双歧杆菌三联活菌胶囊治疗。2组服药5 d。比较2组患儿临床疗效,治疗前后血清总胆红素水平、Hedgehog信号通路相关指标的相对表达水平,治疗后免疫学指标水平,治愈时间及不良反应发生情况。结果观察组治疗总有效率高于对照组[91.9%(114/124)比73.4%(91/124)],差异有统计学意义(P<0.001)。治疗后观察组总胆红素水平低于对照组[(120±23)μmol/L比(184±31)μmol/L],CD;、CD;/CD;比值、免疫球蛋白M水平均高于对照组[(52±12)%比(23±7)%、(1.82±0.58)比(0.80±0.21)、(0.60±0.17)比(0.29±0.12)],差异均有统计学意义(均P<0.05)。治疗后观察组Hedgehog信号通路各指标水平均低于对照组,差异均有统计学意义(均P<0.05)。观察组患儿治愈时间短于对照组[(3.2±0.9)d比(4.3±1.2)d],差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组[13.7%(17/124)比25.0%(31/124)],差异有统计学意义(P=0.024)。结论口服益生菌联合茵栀黄口服液治疗新生儿高胆红素血症疗效可靠,可迅速降低血清胆红素水平,提高患儿免疫力,减少不良反应发生。

Objective To observe the clinical efficacy of oral probiotics combined with Yinzhihuang oral liquid on the treatment of neonatal hyperbilirubinemia and its effect on the immune system.Methods A total of 248 neonates with hyperbilirubinemia who were admitted to the Second Affiliated Hospital of Xi′an Medical University from May 2016 to August 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 124 cases in each group.The control group was treated with Yinzhihuang oral liquid,while the observation group was treated with live combined bifidobacterium,lactobacillus and enterococcus capsules on the basis of the control group.Two groups were treated for 5 days.The clinical efficacy,the serum total bilirubin levels and relative expression levels of related indicators of the Hedgehog signaling pathway before and after treatment,immunological index levels after treatment,average cure time and occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.9%(114/124)vs 73.4%(91/124)](P<0.001).After treatment,the level of total bilirubin in the observation group was lower than that in the control group[(120±23)μmol/L vs(184±31)μmol/L],the levels of CD;,CD;/CD;ratio and immunoglobulin M in the observation group were higher than those in the control group[(52±12)%vs(23±7)%,(1.82±0.58)vs(0.80±0.21),(0.60±0.17)vs(0.29±0.12)](all P<0.05).After treatment,the levels of various indexes of Hedgehog signal pathway in the observation group were lower than those in the control group(all P<0.05).The cure time of neonates in the observation group was shorter than that in the control group[(3.2±0.9)d vs(4.3±1.2)d](P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group[13.7%(17/124)vs 25.0%(31/124)](P=0.024).Conclusions The combination of oral probiotics and Yinzhihuang oral liquid in the treatment of neonatal hyperbilirubinemia has reliable effect.It can quickly reduce serum bilirubin level,improve immunity,and reduce the occurrence of adverse reactions.