初乳口腔涂抹对管饲超低/极低出生体重儿唾液中sIgA含量的影响

Effect of oropharyngeal colostrum administration on salivary secretory IgA levels in extremely/very low birth weight infants fed by gastric tube

目的探讨初乳口腔涂抹对管饲超低/极低出生体重早产儿唾液中分泌型免疫球蛋白A(secretory immunoglobulin A,sIgA)含量的影响。方法选择2020年8月至2021年1月南方医科大学附属深圳妇幼保健院新生儿重症监护病房收治的出生体重<1500 g管饲早产儿90例进行前瞻性研究。随机分为观察组和对照组,观察组每次管饲喂奶前使用初乳涂抹口腔黏膜,每3 h一次,至出生后7 d;对照组按照科室常规每次喂奶前予以生理盐水清洁口腔,其余护理措施均同观察组。分别在生后2 h、生后7 d收集并检测患儿口腔唾液中sIgA含量,应用SPSS 26.0统计软件进行数据分析。结果共有81例早产儿完成研究。观察组(42例)生后7 d唾液中sIgA含量高于生后2 h[15.4(0.6,106.7)μg/ml比0.6(0.0,5.3)μg/ml],差异有统计学意义(P<0.05);对照组(39例)生后7 d唾液中sIgA含量与生后2 h[0.0(0.0,1.4)μg/ml比0.0(0.0,5.2)μg/ml]差异无统计学意义(P>0.05);观察组生后7 d唾液中sIgA含量高于对照组,差异有统计学意义(P<0.05);观察组唾液中sIgA含量与初乳涂抹开始时间成负相关(r=-0.330,P<0.05),与涂抹完成总次数成正相关(r=0.388,P<0.05)。结论初乳口腔涂抹可以提高管饲超低/极低出生体重儿唾液中sIgA含量。

Objective To study the effect of oropharyngeal colostrum administration on salivary secretory IgA(sIgA)levels in extremely/very low birth weight preterm infants fed by gastric tube.Methods Preterm infants with birth weight<1500 g(n=90)hospitalized in neonatal intensive care unit of the Affiliated Shenzhen Maternity&Child Healthcare Hospital of Southern Medical University from August 2020 to January 2021 were enrolled as research subjects.They were assigned into observation group and control group.The observation group accepted oropharyngeal administration of colostrum before being fed by gastric tube once every 3 hours for 7 days.The control group was given normal saline before each feeding.Other nursing interventions were consistent with the observation group.Saliva samples were collected at the 2 hour and 7 day after birth and the levels of slgA were tested.SPSS 26.0 statistical software was applied to analyse the data.Results A total of 81 preterm infants completed this study.The content of salivary sIgA in observation group(42 cases)on 7 day after birth were significantly higher than those on the 2 hour after birth[15.4(0.6,106.7)μg/ml vs.0.6(0.0,5.3)μg/ml](P<0.05).There was no statistically significant difference between the sIgA levels in the saliva of the control group(39 cases)at the 7 postnatal day and 2 hour after birth[0.0(0.0,1.4)μg/ml vs.0.0(0.0,5.2)μg/ml](P>0.05).The content of salivary sIgA in observation group were significantly higher than those in control group on the 7 day after birth,the difference was statistically significant(P<0.05).The salivary sIgA levels in the observation group were negatively correlated with the starting time of oropharyngeal administration of colostrum(r=-0.330,P<0.05),and positively correlated with the total number of oropharyngeal administration of colostrum(r=0.388,P<0.05).Conclusions Oropharyngeal colostrum administration can improve the levels of salivary sIgA of extremely/very low birth weight preterm infants fed by gastric tube.