摘要
目的探究酪酸梭菌二联活菌散联合维生素C对极早产儿胃肠功能、宫外生长发育迟缓发生率的影响。方法选择商丘市第一人民医院2023年1月至2024年7月收治的50例极早产儿,按照随机数字表法分为两组,各25例。均在出生后48 h内开奶,观察组予以肠道维生素免疫调节方案(开奶时服用酪酸梭菌二联活菌散和维生素C),疗程4周,对照组不服用。比较两组胃肠功能、生长速率、免疫功能、炎症因子水平、宫外生长发育迟缓发生率的差异。结果观察组首次排便时间[(19.13±2.88)h]、胎粪排尽时间[(5.23±1.64)d]均短于对照组[(25.18±3.49)h、(6.92±2.08)d],每日自主排便次数[(3.11±0.43)次]多于对照组[(2.06±0.37)次];观察组身长增长速度[(0.96±0.24)cm/周]、头围增长速度[(0.80±0.19)cm/周]、体质量增长速度[(18.12±4.36)g/d]均高于对照组[(0.83±0.16)cm/周、(0.68±0.16)cm/周、(15.39±3.19)g/d],差异有统计学意义(P<0.05);观察组治疗7 d后免疫球蛋白(Ig)G[(9.42±2.36)g/L]、IgA[(1.31±0.32)g/L]、CD4^(+)/CD8^(+)(1.44±0.34)高于对照组[(7.43±1.96)g/L、(1.08±0.30)g/L、(1.17±0.29)],肿瘤坏死因子α(TNF-α)[(11.29±2.31)pg/mL]、白细胞介素-4(IL-4)[(702.21±2.62)pg/mL]水平均低于对照组[(15.43±2.24)pg/mL、(815.28±3.24)pg/mL],干扰素-γ(IFN-γ)[(742.42±81.29)pg/mL]高于对照组[(542.32±76.36)pg/mL],差异有统计学意义(P<0.05)。观察组宫外生长发育迟缓发生率(20.00%)低于对照组(48.00%),差异有统计学意义(χ^(2)=4.367,P=0.037)。结论酪酸梭菌二联活菌散联合维生素C治疗极早产儿能够加快身长、体质量和头围的增长速度,改善胃肠功能及免疫功能,降低炎症因子水平,减少宫外生长发育迟缓的发生。
Objective To investigate the influence of live Clostridium butyricum and Bifidobacterium combined powder combined with vitamin C on gastrointestinal function and extrauterine growth retardation(EUGR)rate in very premature infants.Methods Fifty very premature infants admitted to Shangqiu First People's Hospital from January 2023 to July 2024 were selected and randomly divided into observation group and control group,with 25 cases in each group.All infants were fed within 48 hours after birth.Observation group received an intestinal vitamin immunomodulation regimen(oral administration of live Clostridium butyricum and Bifidobacterium combined powder and vitamin C at the start of feeding),while control group did not.The treatment lasted for 4 weeks.Gastrointestinal function,growth rate,immune function,inflammatory cytokine levels,and the incidence of EUGR were compared between the two groups.Results The first defecation time[(19.13±2.88)h]and meconium excretion time[(5.23±1.64)d]in the observation group were shorter than those in the control group[(25.18±3.49)h and(6.92±2.08)d],and the daily frequency of spontaneous defecation[(3.11±0.43)times]was higher than that in the control group[(2.06±0.37)times].The body length increasing[(0.96±0.24)cm/week],head circumference increasing[(0.80±0.19)cm/week],and body weight in-creasing[(18.12±4.36)g/d]in the observation group were all higher than those in the control group[(0.83±0.16)cm/week,(0.68±0.16)cm/week,and(15.39±3.19)g/d],with statistically significant(P<0.05);After 7 days of treatment,the levels of immunoglobulin(Ig)G[(9.42±2.36)g/L],IgA[(1.31±0.32)g/L],and CD4^(+)/CD8^(+)(1.44±0.34)in the observation group were higher than those in the control group[(7.43±1.96)g/L,(1.08±0.30)g/L,and(1.17±0.29)].The levels of tumor necrosis factor alpha(TNF-α)[(11.29±2.31)pg/mL]and interleukin-4(IL-4)[(702.21±2.62)pg/mL]in the obser-vation group were lower than those in the control group[(15.43±2.24)pg/mL and(815.28±3.24)pg/mL].Interferon-γ(IFN-γ)[(742.42±81.29)pg/mL]in the observation group was higher than that of the control group[(542.32±76.36)pg/mL],and the difference was statistically significant(P<0.05).The incidence of ectopic growth and development delay in the observation group was 20.00%,which was lower than that in the control group(48.00%),and the difference was statistically significant(χ^(2)=4.367,P=0.037).Conclusion Live Clostridium butyricum and Bifidobacterium combined powder combined with vitamin C in the treatment of very premature infants can accelerate growth in body length,weight and head circumference,improve gastroin-testinal and immune functions,reduce inflammatory cytokine levels,and decrease the incidence of extrauterine growth retardation.
作者
刘雨露
樊启红
王战胜
LIU Yulu;FAN Qihong;WANG Zhansheng(Department of Neonatology,The First Affiliated Hospital of Yangtze University,Jingzhou Hubei 434000,China;Neonatal Intensive Care Unit,Shangqiu First People's Hospital,Shangqiu Henan 476100,China)
出处
《天津药学》
2025年第7期790-794,共5页
Tianjin Pharmacy
关键词
酪酸梭菌二联活菌散
联合维生素C
极早产儿
宫外发育
肠道微生物
免疫调节
Live Clostridium butyricum and Bifidobacterium combined powder
Vitamin C
Very premature infants
Extrau-terine growth
Gut microbiota
Immunomodulation
