益生菌早期干预对婴儿生长发育、感染性疾病发生率及肠道菌群修饰作用的研究

发布时间：2018-06-12 06:47

  本文选题：益生菌 + 婴儿　； 参考：《河北医科大学》2013年硕士论文

【摘要】：目的：母乳喂养是婴儿时期营养来源的首要选择，但是并非每个婴儿都能享受母乳的益处，如何解决不能接受母乳喂养婴儿或母乳喂养不足婴儿的营养支持问题成为儿童生长发育与疾病研究的一个前沿课题。益生菌是活的非致病性微生物，定居于宿主肠道，可以调节肠道菌群及其代谢活动，对机体产生有益作用。生命早期配方奶中添加益生菌对婴儿生长发育和疾病的影响目前尚无国内报道。本研究旨在通过观察生命早期含有益生菌的配方奶喂养婴儿呕吐，烦躁哭闹，大便频率及稠厚度等指标，测量不同月龄婴儿身高，体重，头围，胸围和皮下脂肪厚度(subcutaneous fatthickness, SFT)，观察不同喂养方式下婴儿呼吸道感染与感染性腹泻的发病率，并测定婴儿粪便中双歧杆菌(bifidobacteria)数量，了解添加益生菌配方奶的婴幼儿耐受情况，及生命早期益生菌干预对婴儿生长发育的影响、预防感染性疾病中的作用及不同喂养方式下双歧杆菌在肠道中的定植情况，为生命早期添加益生菌对今后健康发展的作用提供理论及临床依据。 方法：选择2011年11月-2012年9月在河北医科大学第三医院和石家庄市第四人民医院出生的新生儿120例，其中男65例，女55例。由益生菌配方奶喂养的婴儿60例，男32例、女28例，其中15例在随访过程中因依从性差或其他原因而脱落，故实际例数为45例，男25例，女20例；由普通配方奶喂养的婴儿60例，，男31例，女29例，其中12例在随访过程中因依从性差或其他原因而脱落，故实际例数48例，男25例，女23例；同期选择两地生后母乳喂养的婴儿60例，男33例，女27例，其中18例在随访过程中因依从性差其他原因退组，故实际例数为42例，男23例，女19例。各组婴儿及其双亲均生活在石家庄市或其周边县市，气候环境，居住环境，饮食环境等相当。各组婴儿出生体重、身长、头围、胸围、性别、皮下脂肪厚度、胎龄和脱落率之间无差异。所有入选对象均在研究开始前签订知情同意书，并获河北医科大学第三医院伦理道德委员会同意。本研究分两部分进行：临床指标观察及测量：随访观察添加益生菌配方奶喂养儿、普通配方奶喂养儿及母乳喂养儿6个月内大便频率及稠厚度、呕吐，烦躁哭闹等指标，了解添加益生菌配方奶喂养儿的耐受情况；通过测量出生第1天、第1个月、第2个月、第3个月、第4个月、第5个月和第6个月龄时婴儿的身高，体重，头围，胸围和皮脂厚度等指标，了解不同喂养方式下婴儿生长发育状况；观察不同喂养方式下婴儿呼吸道感染与感染性腹泻的发生率，了解益生菌在预防感染性疾病中的作用。实验室检测：收集新生儿生后第7天、1个月、3个月、6个月龄时粪便标本，采用荧光定量聚合酶链式反应(Flurogenic Quantitative Polym-erase Chain Reaction,FQ-PCR)技术测定粪便中双歧杆菌(bifidobacteria)数量，了解不同喂养方式下肠道双歧杆菌在肠道中的定植情况。统计分析采用SPSS13.0软件。 结果： 1益生菌喂养儿、普通奶粉喂养儿及母乳喂养儿之间性别、胎龄、体重、身长、头围、胸围、皮下脂肪厚度和脱落率无差异(P均0.05); 2益生菌喂养儿、普通配方奶喂养儿及母乳喂养儿三组之间大便频率、稠厚度、呕吐及烦躁哭闹均无差异(P均0.05)； 3益生菌喂养儿和母乳喂养儿身高和体重在第3个月、4个月、5个月、6个月龄时较普通奶粉喂养组高(P0.05)；益生菌喂养儿和母乳维喂养儿在第3个月、4个月、5个月和6个月龄时身长和体重无差异(P均0.05)。益生菌喂养儿、普通配方奶喂养儿和母乳喂养儿在第1-6个月龄时的头围、胸围和皮脂厚度比较均无差异(P均0.05)。益生菌喂养儿、普通配方奶喂养儿和母乳喂养儿在第1个月和2个月龄时的身长、体重无差异(P0.05); 4益生菌喂养儿、普通配方奶喂养儿和母乳喂养儿在3个月内呼吸道感染和感染性腹泻发病率无差异(P0.05)；但益生菌喂养儿和母乳喂养儿在6个月内感染性腹泻的发病率低于普通奶粉喂养儿（P0.05）；益生菌喂养儿和母乳喂养儿在6个月内感染性腹泻的发病率无差异(P0.05)； 5母乳喂养组婴儿在生后第1个月、3个月和6个月龄时粪便双歧杆菌数量高于普通配方奶喂养组婴儿，差异有统计学意义（P0.05）；益生菌喂养组婴儿在生后第1个月、3个月和6个月时粪便双歧杆菌数量高于普通奶粉喂养组婴儿，差异有统计学意义（P0.05）；益生菌喂养组婴儿在生后第6个月时粪便双歧杆菌数量高于母乳喂养组婴儿，差异有统计学意义（P0.05）；益生菌喂养组、普通奶粉喂养组和母乳喂养组婴儿在生后第7天时粪便双歧杆菌数量比较无差异（P0.05）；益生菌喂养组与母乳喂养组婴儿在生后第1个月和3个月时粪便双歧杆菌数量比较无统计学差异（P0.05）。 结论：生命早期添加双歧杆菌婴儿耐受良好，未发现任何不良反应。生后早期双歧杆菌干预可以增加肠道中双歧杆菌的定植，促进肠道粘膜的成熟和发育，改善肠内微生态环境，利于其他有益菌的定植，更好的修饰肠道菌群结构；生命早期添加双歧杆菌能够促进婴儿的生长发育，表现反映在体重和身高的增加，对胸围、头围和皮下脂肪的增长效应不显著；生命早期添加益生菌能够降低生后6个月内婴儿感染性疾病尤其是感染性腹泻的发生率。
[Abstract]:Objective: breastfeeding is the primary choice for infant nutrition, but not every baby can enjoy the benefits of breast milk. How to solve the problem of nutritional support that can not be breastfed or breastfeeding babies is a leading issue in the study of children's growth and disease. Probiotics are the living non pathogenic factors. Microbes, settled in the gut of the host, can regulate the intestinal flora and its metabolic activities and have a beneficial effect on the body. There is no domestic report on the effects of probiotics on the growth and disease of infants at the early stage of life. This study aims to feed infant vomiting and irritability by observing the early probiotic formula in the early life. To observe the height, weight, head circumference, chest circumference and subcutaneous fat thickness (subcutaneous fatthickness, SFT) of infants of different months of age, to observe the incidence of respiratory infection and infective diarrhea in infants under different feeding methods, and to determine the number of Bifidobacterium (bifidobacteria) in infant feces and to understand the added benefits. The tolerance of infant formula milk, the effect of probiotic intervention on the growth and development of infants in the early life, the role of preventing infectious diseases and the colonization of Bifidobacterium in the intestine under different feeding ways, provide theoretical and clinical basis for the role of probiotics in the early life for the future healthy development.
Methods: 120 newborns born in Third Hospital of Hebei Medical University and fourth people's Hospital of Shijiazhuang in September -2012 in November 2011 were selected, including 65 males and 55 females. 60 cases, 32 men and 28 women were fed by probiotic formula milk, of which 15 cases fell off due to poor compliance or other reasons in the follow-up process, so the actual number of cases was counted. There were 45 cases, 25 males and 20 females, 60 infants, 31 men and 29 women, among which 12 cases were dropped from poor compliance or other reasons in the follow-up process, so there were 48 cases, 25 men and 23 women, and 60, male 33, and 27 cases were chosen in the same period. The number of actual cases was 42 cases, 23 males and 19 females. All the infants and their parents lived in Shijiazhuang or its surrounding counties and cities. The climatic environment, the living environment, the diet environment, etc. were equal. There was no difference between the birth weight, the length, the head circumference, the chest circumference, the sex, the thickness of the subcutaneous fat, the fetal age and the rate of fall. Informed consent was signed before the start of the study and agreed by the ethics committee of the Third Hospital of Hebei Medical University. The study was divided into two parts: observation and measurement of clinical indicators: follow-up observation added probiotic formula feeding children, regular formula milk feeding children and breast-feeding children's stool frequency and consistency within 6 months. To understand the tolerance of supplemented probiotic formula feeding infants, and to understand the height, weight, head circumference, chest circumference and sebum thickness of infants at first days of birth, first months, second months, third months, fourth months, fifth months and sixth months, to understand the growth and development of infants under different feeding methods. To observe the incidence of infantile respiratory infection and infective diarrhea under different feeding methods and to understand the role of probiotics in the prevention of infectious diseases. Laboratory test: collection of fecal specimens at seventh days, 1 months, 3 months and 6 months of age after birth of newborn infants, using Flurogenic Quantitative Polym- by fluorescence quantitative polymerase chain reaction. Erase Chain Reaction, FQ-PCR) technique was used to determine the number of Bifidobacterium (bifidobacteria) in feces, and to understand the colonization of Bifidobacterium in intestinal tract under different feeding methods. The statistical analysis was carried out by SPSS13.0 software.
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