哺乳期补充鼠李糖乳杆菌在预防婴幼儿湿疹以及特应性疾病中的价值  

Value of Lactobacillus rhamnosus supplementation during lactation in preventing infantile eczema and atopic diseases

作　　者：李园园 黄勇 苟洪波 LI Yuanyuan;HUANG Yong;GOU Hongbo(Department of Pediatrics, Changshou District People's Hospital,Chongqing 401220,China)

机构地区：[1]长寿区人民医院儿科新生儿科,重庆401220 [2]长寿区人民医院儿科神经内科,重庆401220

出　　处：《中国微生态学杂志》2019年第6期689-693,共5页Chinese Journal of Microecology

摘　　要：目的探究哺乳期补充鼠李糖乳杆菌对婴幼儿湿疹以及特应性疾病的预防作用。方法选择2015年1月至2016年12月间于我院分娩和定期体检的哺乳期妇女及其新生儿152例,随机数表法分为对照组(76例)和实验组(76例),对照组采用常规哺乳期婴幼儿湿疹预防策略,实验组在此基础上补充鼠李糖乳杆菌。比较两组婴儿的免疫学指标(嗜酸性粒细胞百分比,IgE和特异性IgE)水平、皮肤点刺试验(SPT)阳性率及24个月内湿疹以及特应性疾病的发病情况。结果实验组6个月后的EOS%、IgE、sIgE均明显低于对照组(均P<0.05);对照组和实验组的SPT阳性率分别为15.79%和5.26%,差异有统计学意义(χ^2=4.471,P=0.034)。实验组婴幼儿肠道菌群中双歧杆菌、乳杆菌明显多于对照组(t=6.173,5.070,均P<0.001),而肠球菌及肠杆菌明显少于对照组(t=5.111,5.919,均P<0.001)。对照组婴幼儿的湿疹累积发病率为38.16%(29/76),实验组的湿疹累积发病率为25.00%(19/76),实验组的湿疹发病率明显低于对照组(Log-rank χ^2=3.949,P=0.047)。对照组和实验组婴幼儿的特应性疾病累积发病率分别为17.11%(13/76)和6.58%(5/76),实验组的发生风险明显低于对照组(Log rank χ^2=4.275,P=0.039)。结论哺乳期补充鼠李糖乳杆菌能够有效调节肠道菌群,降低婴幼儿2岁以内的湿疹以及特应性疾病发生风险。Objective To explore the preventive effect of Lactobacillus rhamnosus supplementation on infantile eczema and atopic diseases during lactation. Methods A total of 152 lactating women and their newborns in our hospital from January 2015 to December 2016 were enrolled and randomly divided into the control group(76 cases)or observation group(76 cases).Both groups were given conventional lactation prevention strategy,while the observation group was additionally given Lactobacillus rhamnosus.The immunological parameters(eosinophils,IgE and specific IgE),the positive rate of skin prick test(SPT),and the incidence of eczema and atopic disease within 24 months were compared between the two groups. Results The EOS%,IgE and sIgE in the observation group were significantly lower than those in the control group respectively(t=5.869,3.208,5.847;all P<0.05).The positive rate of SPT in the control group vs observation group was 15.79% vs 5.26%;the difference was statistically significant(χ^2=4.471,P=0.034).The amounts of Bifidobacteria and Lactobacilli in the intestinal flora of infants in the observation group were significantly higher(t=6.173,5.070;all P<0.001),while those of Enterococci and Enterobacter were significantly lower than in the control group(t=5.111,5.919;all P<0.001).The cumulative incidence of eczema was 38.16%(29/76)in control group vs 25.00%(19/76)in observation group,with significantly difference(Log-rank χ^2=3.949,P=0.047).The cumulative incidence of atopic diseases in the control group vs observation group was 17.11%(13/76)vs 6.58%(5/76);the risk in the observation group was significantly lower than in the control group(Log-rank χ^2=4.275,P=0.039). Conclusion Lactobacillus rhamnosus supplementation during lactation can effectively regulate intestinal flora and reduce the risk of eczema and atopic diseases in infants aged≤2 years.

关 键 词：湿疹 特应性疾病 婴幼儿 哺乳期 鼠李糖乳杆菌 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]