早期微生态干预对早产儿黄疸的预防作用及机制研究

摘要

Objective To explore the effect and mechanism of early application of microecological preparation-bifidobacteria agent on jaundice in premature infants.Methods One hundred and fifty premature infants in our hospital were randomly divided into two groups, treatment group and control group.The patients of both groups were subjected to routine treatments.Besides,the patients of treatment group were given live combined bifidobacteria and lactobacilla tablets,0.5 g,3 times a day.Intestinal symptoms were observed and serum bilirubin was detected.The faecal bifidobacteria were consecutively quantified by real-time polymerase chain assays on 3 days and 7 days after birth.Results Compared with that of control group,the incidence of feeding intolerance of treatment group significantly decreased(P < 0.01 ),and the indexes improved in the treatment group:enough feeding time(P < 0.01 ),and the numbers of warm brine enema(P < 0.01 ),serum bilirubin on 3 days after birth decreased(P < 0.01 ),the occurrence of hyperbilirubinemia and duration of jaundice reduced(P < 0.01).the bifidobacteria logarithmic absolute value of treatment group in 3 days and 7 days after birth increased(P <0.01).The level of serum bilirubin on 3 days after birth was negatively correlated with bifidobacteria logarithmic absolute value (r = -0.810,P < 0.01 ).Probiotics related to the occurrence of sepsis were not seen.Conclusion Early use of probiotics in premature infant promoted the colonization of intestinal beneficial bacteria,protect the gastrointestinal function, improve the occurrence of hyperbilirubinemia and jaundice duration reduced.%目的：探讨早期应用微生态调节剂金双歧对早产儿黄疸的影响及作用机制。方法将符合条件的早产儿150例随机分为对照组和试验组，对照组给予常规治疗，试验组在此基础上给予双歧杆菌、乳杆菌、嗜热链球菌三联活菌片治疗，0．5 g／次，3次／d，观察2组患儿喂养及排便情况，监测胆红素，采集第3、7天肠道粪便标本，通过实时 PCR 技术对新生儿粪便中的双歧杆菌属进行定量检测。结果与对照组相比，试验组喂养不耐受发生率低（P ＜0．01），达全胃肠喂养所需时间提前（P ＜0．01），温盐水灌肠次数减少（P ＜0．01），生后第3 天血清胆红素水平降低（P ＜0．01），高胆红素血症发生率降低（P ＜0．01），黄疸持续时间缩短（P ＜0．01）。第3、7天肠道双歧杆菌的数量均明显高于对照组（P ＜0．01），第3 天血清胆红素水平与肠道双歧杆菌数量的对数值呈明显负相关（r ＝－0．810， P ＜0．01），且无益生菌相关性败血症发生。结论早产儿早期应用微生态调节剂金双歧，可以促进肠道益生菌定植，从而改善消化道症状、避免高胆红素血症发生、促进黄疸消退。