谷氨酰胺与无乳糖配方奶喂养对坏死性小肠结肠炎早产儿营养状态、免疫功能及胃肠激素的影响

摘要

目的：探讨谷氨酰胺与无乳糖配方奶喂养对坏死性小肠结肠炎早产儿营养状态、免疫功能及胃肠激素的影响。方法将坏死性小肠结肠炎早产儿60例纳入研究对象，采用随机数字表法分为观察组和对照组各30例，观察组患儿接受谷氨酰胺与无乳糖配方奶喂养，对照组患儿接受谷氨酰胺与母乳喂养，比较2组患儿的营养状态、免疫功能、胃肠道激素水平。结果（1）营养状态：治疗后4周比较，观察组患儿白蛋白、前蛋白含量均明显高于对照组[（112Å．31±15．23） g／L vs．（103．19±13．75） g／L，（41．48±5．61） g／L vs．（32．58±4．46） g／L， P均＜0．05]；（2）免疫功能：治疗后2周比较，观察组患者的CD4＋T细胞以及IgA、IgG、IgM含量均高于对照组[（38．11±3．91）％ vs．（32．52±4．84）％，（13．14±1．45） g／L vs．（10．12±0．73） g／L，（2．86±0．33） g／L vs．（1．77±0．21） g／L，（1．43±0．19） g／L vs．（1．02±0．13） g／L， P均＜0．05]，CD8＋T细胞明显低于对照组[（21．95±3．13）％ vs．（27．51± 3．76）％， P均＜0．05]；（3）胃肠道激素：观察组患儿胃泌素和胃动素含量均明显高于对照组[（292．45±35．82） pg／ml vs．（231．38±29．14） pg／ml，（121．85±16．34） pg／ml vs．（90．45±11．34） pg／ml， P均＜0．05]。结论谷氨酰胺与无乳糖配方奶喂养有助于改善营养状态、免疫功能，提高胃肠道激素含量，从而提高治疗效果。%Objective To investigate the effects of glutamine and lactose free formula feeding on premature infants with necrotizing enterocolitis nutritional status , immune function and gastrointestinal hormone .Methods Sixty premature in-fant with necrotizing enterocolitis were enrolled in the study , they were randomly divided into observation group and control group with 30 cases in each group , the observation group received glutamine and lactose free formula feeding , the control group were received glutamine and breastfeeding , children nutrition status , immune function , gastrointestinal hormone were compared between the 2 groups..Results (1) nutritional status:4 weeks after treatment, albumin, preprotein content in the observation group were significantly higher than those of control group [(112.31 ±15.23) g/L vs.(103.19 ±13.75) g/L, (41.48 ±5.61)g/L vs.(32.58 ±4.46) g/L, P <0.05].(2)Immune function:2 weeks after treatment, CD4+T cells ratio and IgA, IgG, IgM in the observation group were significantly higher than those of control group [(38.11 ±3.91)% vs. (32.52 ±4.84)%, (13.14 ±1.45) g/L vs.(10.12 ±0.73) g/L,(2.86 ±0.33) g/L vs.(1.77 ±0.21) g/L,(1.43 ± 0.19) g/L vs.(1.02 ±0.13) g/L, P <0.05];CD8+T cells ratio was significantly lower than that control group [(21.95 ± 3.13)%vs.(27.51 ±3.76)%, P <0.05].(3) Guthormone levels: gastrin and motilin content in the observation group were significantly higher than those of control group [(292.45 ±35.82) pg/ml vs.(231.38 ±29.14) pg/ml,(121.85 ± 16.34) pg/ml vs.(90.45 ±11.34) pg/ml, P <0.05].Conclusion Glutamine and lactose free formula feeding is helpful to improve the nutritional status , immune function , improve the gastrointestinal tract hormone content , and improve therapeu-tic effect.