摘要
目的探讨危重症早产儿早期微量喂养与其血清、胃液中表皮生长因子(epidermal growth factor,EGF)动态变化之间的关系,评价早期微量喂养(minimal enteral nutrition,MEN)对早产儿胃肠发育及临床情况的影响。方法 125例早产儿分为正常对照组30例,危重早喂组48例, 危重非早喂组47例。用双抗体夹心ABC-ELISA法测其生后1、3、7 d时血清、胃液中EGF的含量。并对其胃肠道喂养耐受情况,生长发育情况进行监测。结果 (1)血清及胃液EGF含量:对照组、危重早喂组的血清、胃液EGF在生后1、3、7 d均呈上升趋势,生后1 d危重早喂组分别为[175.51± 25．74)pg／ml和(631．15±54．47)pg／ml],危重非早喂组[(206．10±13．24)pg／ml和(667．89± 39．58)pg／ml],均低于对照组[(396．03±17．61)pg／ml和(891．03±47．61)pg／ml],P<0．05;生后 3、7 d危重早喂组EGF含量增加[(306．36±10．77)pg／ml和(424．73±37．47)pg／ml],与危重非早喂组[(178．89±39．85)pg／ml和(268．68±10．46)pg／ml]比较,差异有统计学意义(P<0．05)。(2) 临床观察指标:三组喂养不耐受的人数分别为2、5、14例,达足量喂养的时间分别为(20．6±5．7)d、 (27．8±6．1)d和(39．5±4．7)d,住院天数(29．0±4．6)d、(39．0±4．8)d和(48．0±5．6)d,以上三项组间比较均有统计学意义(P<0．05)。生长发育指标:危重早喂组与危重非早喂组患儿相比,前两周体重的增长差异无统计学意义,恢复出生体重时间[(19．8±4．2)d和(25．2±5．1)d]及生后两周组重的增长[(19．09±2．40)g／d和(11．89±3．32)g／d]差异有统计学意义(P<0．05)。出现合并症的情况:三组均无坏死性小肠结肠炎发生。危重早喂组与其他两组比较,感染、贫血、呼吸暂停、低血糖的发病人数差异无统计学意义(P>0．05)。结论危重症早产儿早期微量喂养可以促进EGF的分泌,促进胃肠道发育,较少出现合并症。
Objective To study the serum and gastric juice levels of epidermal growth factor （EGF） in response to early minimal enteral nutrition （MEN） in premature infants with severe illness and evaluate the clinical significance of early MEN. Methods Premature infants with critical score 〈90 were randomly divided into two groups：early MEN group （n= 48） and no early MEN group （n= 47）. Other premature infants （n= 30） without any complications were chosen as normal control. Clinical symptoms were observed and serum and gastric juice EGF levels were monitored at 1, 3, 7 day after birth by EIA. Results The EGF concentrations in the serum and gastric juice in the early MEN group and the non-MEN group were lower than that of the control group on the first day after birth [（175.51±25.74）pg/mland （206.10±13.24）pg/ml vs （396.03±17.61）pg/ml; （631.15±54. 74） pg/ml and （667.89±39.58） pg/ml vs （891.03 ± 47.61）pg/ml, P〈0.05], while significant difference was found between the MEN and non-MEN groups on the 3rd day[（306. 36 ± 10. 77） pg/ml vs （178. 89±39.85）pg/ml,P〈0.05] and the 7th day[（424. 73±37.47）pg/ml vs （268. 68±10.46） pg/ ml, P〈0. 05] after birth. The number of the cases with feeding intolerance was 2,5 and 14 in the MEN, non MEN and control groups, respectively, and the average duration until full enteral feeding was （20.6±5.7）d, （27.8±6.1） d and （39.5 ± 4. 7）d with the length of stay in the hospital was （29.0±4.6）d, （39.0±4.8）d and （48.0±5.6）d in these three groups, respectively（P〈0.05）. No significant difference was found in the weight gain during the first two weeks. However, the duration for recovery to the birth weight was shorter （19.8±4.2）d and more weight gaining was found in the second two weeks after birth （19.09±2.40）g/d in the MEN group than those in the non MEN group [（25.2±5.1）d and （11.89±3.32）g/d, P〈0. 05]. Conclusions Early MEN in premature infants may lead to secretion of EGF, promote the development of gastrointestinal and decrease the incidence of complications.
出处
《中华围产医学杂志》
CAS
2006年第2期103-107,共5页
Chinese Journal of Perinatal Medicine
关键词
表皮生长因子
婴儿
早产
肠道营养
危重病
Epidermal growth factor
Infant, premature
Enteral nutrition
Critical illness
