谷氨酰胺辅助肠内营养、肠外营养改善低出生体重儿喂养不耐受的临床研究

摘要

目的：：分析谷氨酰胺辅助肠内营养、肠外营养改善低出生体重儿喂养不耐受的临床效果.方法：选取中山市陈星海医院2013年5月-2015年6月出生即转入新生儿科的低出生体重儿(LBW)40例,根据营养干预方式不同分为观察组及对照组各20例.对照组患儿接受常规肠内及肠外营养,观察组患儿接受谷氨酰胺辅助肠内营养、肠外营养,对比两组患儿的生长发育指标、营养状态及钙磷水平、胃泌素及胃动素水平、粘膜屏障及免疫功能等差异.结果：观察组患儿接受营养干预后的血清 Leptin、GH、IGF-Ⅰ、Adiponectin 值高于对照组患者,Cor 值低于对照组患者(均 P ＜0．05)；观察组患者接受营养干预后的 TSF、AMC、TP、ALB、钙、磷水平值均高于对照组患儿,ALP 值低于对照组患儿(均 P ＜0．05)；观察组患儿的营养干预后 GAS、MOT 水平值均高于对照组患儿(P ＜0．05)；观察组患儿的干预后外周血CD3＋ T、CD4＋ T、CD4＋/ CD8＋水平高于对照组患儿,D-乳酸、血氨水平低于对照组患儿(均 P ＜0．05).结论：谷氨酰胺辅助肠内营养、肠外营养可以改善低出生体重儿的喂养不耐受情况,从整体上提升患儿的营养状态及生长发育,具有积极的临床意义.%Objective:To analyze effect of glutamine with auxiliary enteral and parenteral nutrition on feeding intoler-ance of low birth weight infants.Methods:A total of 40 low birth weight infants admitted from May 2013 to June 201 5 were se-lected,and were divided into two groups by half according to nutrition invention,observation group and control group.Infants in control group received enteral and parenteral nutrition,and infants in observation group received glutamine with auxiliary en-teral and parenteral nutrition.Growth and development indexes,nutrition status,calcium,phosphorus,gastrin,motilin,mu-cosa barrier,immune function,etc were observed and compared.Results:After intervention,Leptin,GH,IGF-Ⅰ and Adi-ponectin were significantly higher,and Cor was significantly lower in observation group (P <0.05).TSF,AMC,TP,ALB, calcium and phosphorus were significantly higher,and ALP was significantly lower in observation group (P <0.05).CD3 + T, CD4 + T and CD4 +/ CD8 + were significantly higher,and D-lactic acid,blood ammonia were significantly lower in observation group (P <0.05).Conclusions:Glutamine with auxiliary enteral and parenteral nutrition can improve feeding intolerance of low birth weight infants,and promote nutrition status,growth and development.