不同时间建立肠道营养对极低出生体重儿T淋巴细胞亚群的影响研究

Study on the effect of establishing enteral nutrition at different times on T-lymphocyte subsets in very low birth weight infants

目的探讨不同时期建立肠道营养对极低出生体重(VLBW)儿的免疫功能(T淋巴细胞亚群)的数值变化。方法选取南宁市第二人民医院2021—2023年新生儿重症监护病房(NICU)收治的符合纳入标准的VLBW儿90例作为研究对象,依据建立肠道营养时间分为试验组(出生后3 d内)、对照1组(出生后3~7 d)、对照2组(出生后7 d后),每组各30例。统计分析三组T淋巴细胞亚群、感染性疾病发生情况、住院时间、住院费用。结果出生后第20天,试验组患儿CD3^(+)、CD4^(+)水平以及CD4^(+)/CD8^(+)值均高于对照1、2组,差异有统计学意义(P<0.05)。试验组患儿感染性疾病发生率低于对照1、2组,差异有统计学意义(P<0.05)。试验组患儿住院时间短于对照1、2组,且对照1组患儿住院时间短于对照2组,差异有统计学意义(P<0.05);试验组患儿住院费用低于对照1、2组,差异有统计学意义(P<0.05)。结论早期建立VLBW儿肠道营养预期可提高新生儿的细胞免疫功能,降低VLBW儿感染性疾病的感染率及降低感染程度,缩短住院时间,减少住院费用,为提供早期建立肠道营养可提高新生儿细胞免疫力提供理论依据。

Objective To explore the numerical changes in the immune function(T-lymphocyte subset)of establishing enteral nutrition in very low birth weight(VLBW)infants at different stages.Methods A total of 90 infants with VLBW who met the inclusion criteria and were admitted to the neonatal intensive care unit(NICU)of the Second Nanning People’s Hospital from 2021 to 2023 were selected as the study subjects.According to the time of establishing enteral nutrition,they were divided into the test group(within 3 days after birth),the control group 1(3-7 days after birth),and the control group 2(7 days after birth),with 30 cases in each group.The T-lymphocyte subsets,incidence of infectious diseases,hospitalization time,and hospitalization expenses of the two groups were statistically analyzed.Results On the 20th day after birth,the proportions of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in children in the test group were higher than those in children in the control group 1 and control group 2,with statistically significant differences(P<0.05).The incidence of infectious diseases in children in the test group was lower than that in children in control group 1 and control group 2,with statistically significant differences(P<0.05).The hospitalization time of the test group was shorter than that of the control group 1 and control group 2,and the hospitalization time of the control group 1 was shorter than that of the control group 2,with statistically significant differences(P<0.05).The hospitalization expenses of the test group were lower than those of the control group 1 and control group 2,with statistically significant differences(P<0.05).Conclusion The early establishment of enteral nutrition for very low birth weight infants can improve the cellular immune function of newborns,reduce the infection rate and degree of infectious diseases in very low birth weight infants,shorten the length of hospitalization time,and reduce hospitalization expenses,which provides a theoretical basis for the opinion that early establishment of enteral nutrition can improve neonatal cellular immunity.