非营养性吸吮对早产儿营养胰岛素及生长抑素水平的影响  

Effects of non-nutritive sucking on nutrient and plasma insulin and somatostatin levels in premature infants

作　　者：岳晓红[1] 赵翠霞[2] 王红宇[3] 芦惠[3] 薛辛东[3] 

机构地区：[1]沈阳医学院附属中心医院儿科,辽宁沈阳110024 [2]沈阳市苏家屯区中心医院儿科,辽宁沈阳110103 [3]中国医科大学第二临床学院儿科,辽宁沈阳110003

出　　处：《中国当代儿科杂志》2004年第4期277-280,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的　非营养性吸吮 (NNS)对早产儿的有益作用尚存在不同意见 ,该文探讨了NNS对早产儿营养、血浆胰岛素 (INS)及生长抑素 (SS)水平的影响。方法　将 38例需经鼻胃管喂养的健康早产适于胎龄儿 ,随机分成NNS和无非营养性吸吮组 (N NNS)两组 ,用同一种配方乳喂养 ,并用放射免疫法测定INS、SS水平。结果　NNS组恢复出生体重时间 8.8± 3.7d较N NNS组 11.1± 3.0d缩短 ,差异有显著性 (P <0 .0 5 ) ,1周、2周时体重、身长、头围的变化无差异 (均P >0 .0 5 ) ;NNS组肠道营养热能达每日 4 18.4kJ/kg 的时间为 12 .3± 5 .1d较N NNS组 15 .7± 5 .2d缩短 ,差异有显著性 (P <0 .0 5 ) ;鼻胃管留置时间NNS组为 13± 10d ,N NNS组为 17± 12d ,差异无显著性 (P >0 .0 5 )。NNS组胃残留的发生率 (16 .7% )较N NNS组 (5 0 % )减少 (P <0 .0 5 )。早产儿喂奶后 1,2周INS水平NNS组为 37.1± 11.3μU/ml、5 0 .3± 18.4 μU/ml高于N NNS组 2 9.6± 8.8μU/ml、4 0±9.9μU/ml,而SS水平NNS组 4 5 4 .6± 136 .4 pg/ml,5 95 .6± 172 .1pg/ml 低于N NNS组 5 95 .3± 2 6 0 .1pg/ml,72 7.2± 2 2 0 .8pg/ml,差异均有显著性意义 (均P <0 .0 5 )。结论　NNS可促进INS的分泌 ,抑制SS的分泌 ,NNS有利于早产儿生后胃肠道的继续发?Objective In view of the different opinions on the effects of non-nutritive sucking (NNS) on premature infants, this paper aims at evaluating the effects of NNS on nutrient and gastrointestinal hormones insulin (INS) and somatostatin (SS) levels in premature infants. Methods Thirty-eight healthy, appropriate for gestational age, premature infants who accepted intermittent nasogastric feeding (INGF) were randomly assigned into a NNS group and a non-NNS group according to INGF with and without NNS. They were fed with the same milk formula. Plasma INS and SS levels were detected by radioimmunoassay (RIA). Results The birth-weight regaining time in the NNS group was significantly shorter than that in the N-NNS group ( 8.8± 3.7 d vs 11.1± 3.0 d; P< 0.05). Within two weeks after feeding, there were no significant differences in the increase of body weight, length and head circumference between the two groups. The time of reaching 418.4 kJ/kg of caloric intake daily by enteral feeding in the NNS group was significantly shorter than that in the N-NNS group ( 12.3± 5.1 d vs 15.7± 5.2 d; P< 0.05); while the feeding time through the nasogastric tube was the same for both groups. There was a lower incidence of gastric residue in the NNS group ( 16.7%) compared with that in the N-NNS group (50%) (P< 0.05). After a week of initial feeding, the plasma INS level in the NNS group was significantly higher than that in the N-NNS group ( 37.1± 11.3 μU/ml vs 29.6± 8.8 μU/ml; P< 0.05). By the end of the second week the plasma INS level in the NNS group was also higher than that in the N-NNS group ( 50.3± 18.4 μU/ml vs 40.0± 9.9 μU/ml; P< 0.05). The plasma SS level in the NNS group was significantly lower than that in the N-NNS group by the end of both the first and second weeks ( 454.6± 136.4 pg/ml vs 595.3± 260.1 pg/ml and 595.6± 172.1 pg/ml vs 727.2± 220.8 pg/ml; both P< 0.05). Conclusions NNS can promote INS secretion and suppress SS secretion, which is of benefit to gastr

关 键 词：非营养性吸吮 肠道营养 胃肠激素 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]