早期微量喂养联合肠外营养治疗对早产儿肠道菌群及免疫功能的影响

Effect of early micro feeding combined with parenteral nutrition on intestinal flora and immune function of premature infants

目的探讨早期微量喂养联合肠外营养治疗对早产儿肠道菌群及免疫功能的影响。方法选取2018年1月至2021年1月陕西省三二〇一医院新生儿科出生的低体重早产儿126例作为研究对象,采用随机数字表法将研究对象分为对照组和实验组,每组63例。对照组接受常规静脉喂养,实验组接受肠外营养联合早期微量喂养,对比两组患儿恢复情况、胃泌素水平、体重增长、肠道菌群(乳杆菌、双歧杆菌)及免疫功能(CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)比值)改善情况,分析患儿喂养第14天时肠道菌群与免疫功能的相关性。结果与对照组比较,实验组呕吐消失时间、腹胀症状消失时间、恢复出生体重时间、达全胃肠喂养时间均明显缩短,差异有统计学意义(P<0.05);实验组在喂养第14天时胃泌素水平及体重均高于对照组,差异有统计学意义(P<0.05);实验组在喂养第7天、14天时乳杆菌、双歧杆菌水平高于对照组,差异有统计学意义(P<0.05);实验组治疗后CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)比值均高于对照组,差异有统计学意义(P<0.05);乳杆菌水平与患儿CD4^(+)、CD4^(+)/CD8^(+)比值呈正相关(r=0.564、0.681,P<0.05),双歧杆菌与患儿CD4^(+)、CD4^(+)/CD8^(+)比值呈正相关(r=0.594、0.733,P<0.05)。结论对低体重(体重<1500 g)早产儿实施肠外营养联合早期微量喂养可有效促进患儿体重恢复,改善胃泌素水平及肠道菌群水平,促进患儿免疫功能建立。

Objective To explore the effect of early micro feeding combined with parenteral nutrition on intestinal flora and immune function of premature infants.Methods A total of 126 low-weight preterm infants born in No.3201 Hospital of Shaanxi Province from January 2018 to January 2021 were selected as research objects.The subjects were divided into control group and experimental group by random number table method,with 63 cases in each group.The control group received conventional intravenous feeding,and the experimental group received parenteral nutrition combined with early micro feeding.The recovery,gastrin level,weight gain,intestinal flora(lactobacillus,bifidobacterium)and immune function(CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)ratio)of the children in the two groups were compared.The correlation between intestinal flora and immune function on the 14th day of feeding was analyzed.Results Compared with the control group,the time of disappearance of vomiting,the time of disappearance of abdominal distension,the time of recovery of birth weight and the time of total intestinal feeding in the experimental group were significantly shortened,with statistical significance(P<0.05).On the 14th day of feeding,the gastrin level and body weight of the experimental group were higher than those of the control group,the difference was statistically significant(P<0.05).The levels of lactobacillus and bifidobacterium in the experimental group were higher than those in the control group on the 7th and 14th day of feeding,and the difference was statistically significant(P<0.05).CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)ratio in the experimental group were higher than those in the control group after treatment,and the difference was statistically significant(P<0.05).Lactobacillus level was positively correlated with CD4^(+),CD4^(+)/CD8^(+)ratio(r=0.564,0.681,P<0.05),bifidobacterium level was positively correlated with CD4^(+),CD4^(+)/CD8^(+)ratio(r=0.594,0.733,P<0.05).Conclusion Parenteral nutrition combined with early micro feeding in preterm infants with low body mass(body mass<1500 g)can effectively promote weight recovery,improve gastrin levels and intestinal flora levels,and promote the establishment of immune function in children.