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目的探讨补充益生菌对胎粪吸入综合征婴儿免疫功能状况的作用。方法选取2013年1月—2015年1月孝感市中心医院新生儿科住院治疗的胎粪吸入综合征患儿49名,按区组随机化原则分为治疗组(Ⅰ组)与观察组(Ⅱ组),选取同期因高危因素住院排除疾患的健康足月儿34名为对照组(Ⅲ组)。分别于1月龄、3月龄、6月龄、12月龄定期随访,检测外周血IgG、IgM、IgA及肿瘤坏死因子(TNF-α)水平,统计1年内喘息≥4次的人次,对结果进行分析。结果 1月龄血清IgM在Ⅰ组、Ⅱ组、Ⅲ组分别为(0.057±0.049)g/L、(0.059±0.013)g/L、(0.030±0.037)g/L,差异有统计学意义(P<0.05)。6月龄血清IgG在Ⅰ组、Ⅱ组及Ⅲ组分别为(6.233±1.213)g/L、(5.230±1.158)g/L、(7.238±1.612)g/L;血清IgA在Ⅰ组、Ⅱ组、Ⅲ组分别为(0.367±0.215)g/L、(0.348±0.152)g/L、(0.482±0.291)g/L;血清TNF-α在Ⅰ组、Ⅱ组与Ⅲ组分别为(2.006±1.129)、(2.520±1.188)、(1.191±0.319),差异均有统计学意义(P<0.05)。12月龄血清IgGⅠ组、Ⅱ组及Ⅲ组分别为(8.332±1.782)g/L、(7.150±1.238)g/L、(8.672±1.912)g/L;血清在IgM在Ⅰ组、Ⅱ组、Ⅲ组分别为(1.487±0.533)g/L、(1.058±0.390)g/L、(1.548±0.853)g/L;血清IgAⅠ组、Ⅱ组及Ⅲ组分别为(0.423±0.258)g/L、(0.332±0.191)g/L、(0.512±0.398)g/L;血清TNF-ɑ在Ⅰ组、Ⅱ组与Ⅲ组分别为(1.289±0.293)ng/ml、(2.127±1.276)ng/ml、(1.223±0.363)ng/ml,差异均有统计学意义(P<0.05)。12月龄内喘息≥4次人次Ⅰ组为0例(0/29),Ⅱ组为3例(3/20),Ⅲ组为1例(1/34),喘息发生率Ⅱ组明显高于Ⅰ组、Ⅲ组,但差异无统计学意义(P<0.05)。结论补充益生菌对胎粪吸入综合征婴儿免疫功能有一定改善,有降低儿童哮喘发生风险的可能。
Objective To investigate the effect of probiotics supplementation on immune function in infants with meconium aspiration syndrome. Methods 49 children with meconium aspiration syndrome admitted to Department of Neonatology, Xiaogan Central Hospital from January 2013 to January 2015 were divided into treatment group (group Ⅰ) and observation group (group Ⅱ) ), 34 healthy full-term infants were selected as control group (group Ⅲ). Peripheral blood serum levels of IgG, IgM, IgA and tumor necrosis factor (TNF-α) were measured at 1-month, 3-month, 6-month and 12-month follow-up. Results were analyzed. Results The serum IgM of 1-month-old group was (0.057 ± 0.049) g / L, (0.059 ± 0.013) g / L and (0.030 ± 0.037) g / L respectively in group Ⅰ, group Ⅱ and group Ⅲ P <0.05). The level of serum IgG in group Ⅰ, group Ⅱ and group Ⅲ were (6.233 ± 1.213) g / L and (5.230 ± 1.158) g / L and (0.367 ± 0.215) g / L, (0.348 ± 0.152) g / L and (0.482 ± 0.291) g / L respectively in group Ⅲ and group Ⅲ. The levels of TNF-α in group Ⅰ, Ⅱ and Ⅲ were (2.006 ± 1.129), (2.520 ± 1.188) and (1.191 ± 0.319), respectively, with statistical significance (P <0.05). The levels of serum IgM in group Ⅰ and group Ⅱ at 12 months of age were (8.332 ± 1.782) g / L, (7.150 ± 1.238) g / L and (8.672 ± 1.912) g / , (1.487 ± 0.533) g / L, (1.058 ± 0.390) g / L, and (1.548 ± 0.853) g / L respectively in group Ⅲ and (0.423 ± 0.258) g / L, (0.332 ± 0.191) g / L and (0.512 ± 0.398) g / L, respectively. The levels of TNF-血 in serum of group Ⅰ, Ⅱ and Ⅲ were (1.289 ± 0.293) ng / /ml,(1.223 ± 0.363) ng / ml, the difference was statistically significant (P <0.05). The wheezing ≥ 4 times in 12 months old was 0 case (0/29) in group Ⅰ, 3 cases (3/20) in group Ⅱ, 1 case (1/34) in group Ⅲ, the incidence of wheezing in group Ⅱ was significantly higher than that in group Ⅱ Ⅰ group, Ⅲ group, but the difference was not statistically significant (P <0.05). Conclusion Supplementation of probiotics on infant meconium aspiration syndrome has some improvement in immune function, may reduce the risk of childhood asthma.