输血对早产儿喂养不耐受及肠道菌群的影响  

Effects of blood transfusion on feeding intolerance and gut microbiome in preterm infants

作　　者：曾超 吴迪 丘文 周宏伟[2] 沈薇[1] ZENG Chao;WU Di;QIU Wen;ZHOU Hongwei;SHEN Wei(Department of Neonatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong;Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong, China)

机构地区：[1]南方医科大学南方医院新生儿科,广州510515 [2]南方医科大学珠江医院检验医学部,广州510282

出　　处：《临床检验杂志》2021年第8期561-565,共5页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(81925026)。

摘　　要：目的分析早产儿输血后喂养不耐受(FI)发病率及肠道菌群的变化。方法纳入南方医科大学南方医院住院诊治早产儿,根据生后第1周后是否输注红细胞,分为输血组和对照组,回顾性分析两组患儿的临床资料、FI情况,采用卡方检验及t检验比较组间差异;采集输血后2周内新鲜粪便样本,进行16S rRNA V4区基因片段扩增及Illumina iSeq100测序,采用QIIME软件及R语言比较肠道菌群16S rRNA测序数据。结果输血组FI发病率(85.71%)明显高于对照组(36.84%)(P<0.05);在减量喂养策略下,两组个体症状类型、达全胃肠内喂养时间及住院时长差异均无统计学意义;输血组肠道菌群中双歧杆菌、肠球菌及阿克曼氏菌较对照组减少,葡萄球菌及寡养单胞菌增多。结论输血是早产儿FI的危险因素,特征性菌群变化可能是输血相关性FI的重要原因。Objective To analyze the incidence of feeding intolerance(FI)and the changes of gut microbiome in preterm infants after blood transfusion.Methods Thirty-three preterm infants were selected in Nanfang Hospital of Southern Medical University and divided into two groups:blood transfusion group and control group according to history of red blood cells transfusion during the first week after birth.The clinical data and the incidences of feeding intolerance in the two groups were analyzed retrospectively and Chi-square test and t test were used to compare the differences between the two groups.The fecal samples of the preterm infants were collected within 2 weeks after blood transfusion,and amplification of 16S rRNA V4 region gene fragment and Illumina iSeq100 sequencing were performed.The 16S rRNA sequencing data of gut microbiome were compared using QIIME software and R language.Results The incidence of feeding intolerance in the blood transfusion group(85.71%)was significantly higher than that of control group(36.84%)(P<0.05).With reduced feeding strategy,there were no significant differences for individual symptom types,full enteral feeding time and length of hospitalization between the two groups.Compared with control group,Bifidobacterium,Enterococcus and Akkermansia in the blood transfusion group were decreased,while Staphylococcus and Stenotrophomonas were increased.Conclusion Blood transfusion should be a risk factor for feeding intolerance in preterm infants,and the characteristic changes of gut microbiome may be an important reason for feeding intolerance associated with blood transfusion.

关 键 词：输血 早产儿 喂养不耐受 肠道菌群 

分 类 号：R446[医药卫生—诊断学]