益生菌对早产极低出生体重儿系统水平细胞因子的影响及临床意义
发布时间：2018-12-06 15:20
【摘要】：目的 探讨在早产极低出生体重儿喂养开始时预防性口服益生菌，对系统水平促炎性细胞因子及抗炎性细胞因子水平的调节及其临床意义。 方法 根据纳入标准，将2011年1月1日至10月31日期间，在我院产科分娩的早产极低出生体重儿随机分成两组，益生菌组及对照组，益生菌组在开始接受肠内喂养时给予预防性口服益生菌制剂（培菲康，0.5g，bid，含活菌量约为1.0×10^7cfu/g，连续服用28天），对照组不添加益生菌喂养，实验时长为28天。记录两组病例围产期相关情况及出生一般情况，记录实验期间的喂养情况、体重增长、住院期间并发症发生情况，于出生第1天及生后第28天抽取动脉血应用酶联免疫吸附检测法分别检测血清中的细胞因子IL-10、TNF-及TGF-的变化，并进行统计分析。 结果 1.两组病例在围产期相关因素及出生史上存在的差异无统计学意义(p0.05)。 2.益生菌组病例出现肺炎比例明显低于对照组(6.7%vs26.7%)，差异有统计学意义(p=0.038)，益生菌组病例败血症发病比例及使用广谱抗生素的比例低于对照组，但差异无统计学意义(p0.05)。 3.益生菌组病例在实验期间出现喂养不耐受比例低于对照组(10.0%vs33.3%)，差异有统计学意义(p=0.028)；益生菌组病例在生后第28天时达到全肠内喂养比例明显多于对照组(93.3%vs73.3%)，差异有统计学意义(p=0.038)。 4.两组病例在出生平均体重上的差异无统计学意义(p=0.421)；在生后第21天时，益生菌组病例体重平均增长较对照组高，但差异无统计学意义(p=0.118)；在生后第28天时，益生菌组病例体重增长水平明显高于对照组，差异有统计学意义(p=0.043)。 5.益生菌组与对照病例在出生时测得IL-10水平分别为(27.59±2.29)(pg/ml)及(27.93±2.70)(pg/ml)， TGF-水平分别为(12.61±1.46)(ng/ml)及(12.08±1.51)(ng/ml)，TNF-水平分别为(54.45±3.81)(pg/ml)及(53.55±3.19)(pg/ml)，三者差异无统计学意义(IL-10为p=0.707、TNF-为p=0.487、TGF-为p=0.333)；在生后第28天时，益生菌组病例IL-10水平为(38.39±2.74)(pg/ml)，对照组则为(36.92±1.50)(pg/ml)，益生菌组病例测得TGF-的平均水平为(19.85±2.68)(ng/ml)，对照组则为(17.23±3.02)(ng/ml)，IL-10及TGF-的平均水平均为益生菌组明显高于对照组，且差异有统计学意义(p=0.043及p=0.006)；而益生菌TNF-的水平为(85.63±9.41)(pg/ml)，显著低于对照组(96.60±10.09)(pg/ml)，且差异有统计学意义(p=0.001)。 结论 1.预防性口服益生菌可明显上调循环中IL-10、TGF-的水平，下调TNF-水平，从而保持早产儿系统水平促炎性和抗炎性细胞因子间的平衡。 2.口服益生菌并无增加败血症、肺炎、坏死性小肠结肠炎感染的比例。 3.预防性口服益生菌可改善早产极低出生体重儿喂养耐受性，缩短达到全肠内喂养的时间，加快体重增长的进度。
[Abstract]:Objective to investigate the regulation of probiotic probiotics on systemic proinflammatory cytokines and anti-inflammatory cytokines at the beginning of preterm very low birth weight infant feeding and its clinical significance. Methods from January 1 to October 31, 2011, premature infants with very low birth weight were randomly divided into two groups: probiotics group and control group. Probiotics group was given prophylactic oral probiotics (Peifeikang, 0.5gbid, containing about 1.0 脳 10 ^ 7cfu-g-1 / g for 28 days), while the control group did not add probiotic feeding for 28 days. The perinatal correlation and general situation of birth, feeding status, weight gain and complications during hospitalization were recorded in the two groups. The changes of serum cytokines IL-10,TNF- and TGF- were detected by enzyme-linked immunosorbent assay (Elisa) on the first day of birth and 28 days after birth. Result 1. There was no significant difference in perinatal factors and birth history between the two groups (p 0.05). 2. The incidence of pneumonia in probiotics group was significantly lower than that in control group (6.7 vs 26.7%), and the difference was statistically significant (p0.038). The incidence rate of septicemia and the proportion of using broad-spectrum antibiotics in probiotics group were lower than those in control group. But the difference was not statistically significant (p 0.05). 3. The rate of feeding intolerance in probiotics group was significantly lower than that in control group (10.0 vs 33.3%), and the difference was statistically significant (p0.028). The proportion of total enteral feeding in probiotics group was significantly higher than that in control group on the 28th day after birth (93. 3% vs 73. 3%), and the difference was statistically significant (p0. 038). 4. There was no significant difference in average birth weight between the two groups (p0. 421), but the average weight increase in probiotics group was higher than that in the control group on the 21st day after birth (p0. 118). On the 28th day after birth, the weight gain level of probiotics group was significantly higher than that of control group (p0.043). 5. The levels of IL-10 in probiotics group and control group were (27.59 卤2.29) (pg/ml) and (27.93 卤2.70) (pg/ml) at birth, respectively. TGF- levels were (12.61 卤1.46) (ng/ml) and (12.08 卤1.51) (ng/ml), TNF- levels were (54.45 卤3.81) (pg/ml) and (53.55 卤3.19) (pg/ml), respectively. There was no significant difference among the three groups (IL-10 was 0.707 TNF- was 0.487TGF- was p0.333); On the 28th day after birth, the levels of IL-10 in probiotics group were (38.39 卤2.74) (pg/ml) and (36.92 卤1.50) (pg/ml) in control group. The average level of TGF- was (19.85 卤2.68) (ng/ml) in probiotics group and (17.23 卤3.02) (ng/ml) in control group. The average level of IL-10 and TGF- in probiotics group was significantly higher than that in control group. The difference was statistically significant (p0. 043 and p0. 006). The level of probiotic TNF- was (85.63 卤9.41) (pg/ml), which was significantly lower than that of the control (96.60 卤10.09) (pg/ml), and the difference was statistically significant. Conclusion 1. Prophylactic oral probiotics can significantly up-regulate the level of IL-10,TGF- in circulation and down-regulate the level of TNF- so as to maintain the balance between systemic prophylaxis and anti-inflammatory cytokines in premature infants. 2. Oral probiotics did not increase the rates of septicemia, pneumonia, and necrotizing enterocolitis. 3. Prophylactic oral probiotics can improve the tolerance of premature very low birth weight infants, shorten the time to complete enteral feeding, and accelerate the progress of weight gain.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.6
本文编号：2366243
[Abstract]:Objective to investigate the regulation of probiotic probiotics on systemic proinflammatory cytokines and anti-inflammatory cytokines at the beginning of preterm very low birth weight infant feeding and its clinical significance. Methods from January 1 to October 31, 2011, premature infants with very low birth weight were randomly divided into two groups: probiotics group and control group. Probiotics group was given prophylactic oral probiotics (Peifeikang, 0.5gbid, containing about 1.0 脳 10 ^ 7cfu-g-1 / g for 28 days), while the control group did not add probiotic feeding for 28 days. The perinatal correlation and general situation of birth, feeding status, weight gain and complications during hospitalization were recorded in the two groups. The changes of serum cytokines IL-10,TNF- and TGF- were detected by enzyme-linked immunosorbent assay (Elisa) on the first day of birth and 28 days after birth. Result 1. There was no significant difference in perinatal factors and birth history between the two groups (p 0.05). 2. The incidence of pneumonia in probiotics group was significantly lower than that in control group (6.7 vs 26.7%), and the difference was statistically significant (p0.038). The incidence rate of septicemia and the proportion of using broad-spectrum antibiotics in probiotics group were lower than those in control group. But the difference was not statistically significant (p 0.05). 3. The rate of feeding intolerance in probiotics group was significantly lower than that in control group (10.0 vs 33.3%), and the difference was statistically significant (p0.028). The proportion of total enteral feeding in probiotics group was significantly higher than that in control group on the 28th day after birth (93. 3% vs 73. 3%), and the difference was statistically significant (p0. 038). 4. There was no significant difference in average birth weight between the two groups (p0. 421), but the average weight increase in probiotics group was higher than that in the control group on the 21st day after birth (p0. 118). On the 28th day after birth, the weight gain level of probiotics group was significantly higher than that of control group (p0.043). 5. The levels of IL-10 in probiotics group and control group were (27.59 卤2.29) (pg/ml) and (27.93 卤2.70) (pg/ml) at birth, respectively. TGF- levels were (12.61 卤1.46) (ng/ml) and (12.08 卤1.51) (ng/ml), TNF- levels were (54.45 卤3.81) (pg/ml) and (53.55 卤3.19) (pg/ml), respectively. There was no significant difference among the three groups (IL-10 was 0.707 TNF- was 0.487TGF- was p0.333); On the 28th day after birth, the levels of IL-10 in probiotics group were (38.39 卤2.74) (pg/ml) and (36.92 卤1.50) (pg/ml) in control group. The average level of TGF- was (19.85 卤2.68) (ng/ml) in probiotics group and (17.23 卤3.02) (ng/ml) in control group. The average level of IL-10 and TGF- in probiotics group was significantly higher than that in control group. The difference was statistically significant (p0. 043 and p0. 006). The level of probiotic TNF- was (85.63 卤9.41) (pg/ml), which was significantly lower than that of the control (96.60 卤10.09) (pg/ml), and the difference was statistically significant. Conclusion 1. Prophylactic oral probiotics can significantly up-regulate the level of IL-10,TGF- in circulation and down-regulate the level of TNF- so as to maintain the balance between systemic prophylaxis and anti-inflammatory cytokines in premature infants. 2. Oral probiotics did not increase the rates of septicemia, pneumonia, and necrotizing enterocolitis. 3. Prophylactic oral probiotics can improve the tolerance of premature very low birth weight infants, shorten the time to complete enteral feeding, and accelerate the progress of weight gain.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.6
【参考文献】
相关期刊论文 前3条
1 中华医学会儿科学分会新生儿学组 ,余加林,吴仕孝;新生儿败血症诊疗方案[J];中华儿科杂志;2003年12期
2 蔡威;汤庆娅;陶晔璇;冯一;;中国新生儿营养支持临床应用指南[J];中华儿科杂志;2006年09期
3 柯丹红,李联侨,高璇璇,许嘉玲;早产儿免疫功能的研究[J];中国优生与遗传杂志;2002年03期
，本文编号：2366243
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2366243.html
最近更新
教材专著
