不同肠内营养开始时间对极低出生体重儿肠道菌群及代谢产物影响的前瞻性研究  

Influence of enteral feeding initiation time on intestinal flora and metabolites in very low birth weight infants: a prospective study

作　　者：申玉洁[1] 李禄全[1] 魏璐 张先红[1] 赵文静[1] 刘晓晨 吴利平[1] SHEN Yu-Jie;LI Lu-Quan;WEI Lu;ZHANG Xian-Hong;ZHAO Wen-Jing;LIU Xiao-Chen;WU Li-Ping(Department of Neonatology,Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院新生儿科/国家儿童健康与疾病国家临床研究中心/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室,重庆400014

出　　处：《中国当代儿科杂志》2022年第4期433-439,共7页Chinese Journal of Contemporary Pediatrics

摘　　要：目的 探讨不同肠内营养开始时间对极低出生体重儿肠道菌群及代谢产物的影响。方法 选取2020年6~12月重庆医科大学附属儿童医院新生儿科收治的29例极低出生体重儿为研究对象,根据生后肠内营养开始时间(开奶时间)不同分为<24 h组(n=15)和24~72 h组(n=14)。采集患儿住院第2周和第4周的粪便标本,采用16S rDNA高通量测序和气相色谱-质谱法分别分析粪便样本的菌群和短链脂肪酸(short-chain fatty acids,SCFAs)。结果 菌群结果显示,生后第2周和第4周2组间Chao指数(反映菌群丰富度)和Shannon指数(反映菌群多样性)差异无统计学意义(P>0.05)。菌群组成分析中,生后第2周和第4周2组间主要菌群在门、属水平上差异无统计学意义(P>0.05)。2组SCFAs比较显示,开奶时间<24 h组第4周丙酸高于24~72 h组(P<0.05),而2组SCFAs总量及其他各SCFAs含量差异无统计学意义(P>0.05)。结论 较早开始肠内营养对极低出生体重儿肠道菌群多样性和丰富度无影响,但24 h内开始肠内营养可以使代谢产物丙酸水平增高。Objective To study the influence of enteral feeding initiation time on intestinal flora and metabolites in very low birth weight(VLBW) infants.Methods A total of 29 VLBW infants who were admitted to the Department of Neonatology,Children’s Hospital of Chongqing Medical University,from June to December,2020,were enrolled as subjects.According to the enteral feeding initiation time after birth,the infants were divided into two groups:<24 hours(n=15) and 24-72 hours(n=14).Fecal samples were collected at weeks 2 and 4 of hospitalization,and 16S r DNA highthroughput sequencing and gas chromatography-mass spectrometry were used to analyze the microflora and short-chain fatty acids(SCFAs) respectively in fecal samples.Results The analysis of microflora showed that there was no significant difference between the two groups in Chao index(reflecting the abundance of microflora) and Shannon index(reflecting the diversity of microflora) at weeks 2 and 4 after birth(P>0.05).The analysis of flora composition showed that there was no significant difference in the main microflora at the phylum and genus levels between the two groups at weeks 2 and 4 after birth(P>0.05).The comparison of SCFAs between the two groups showed that the <24 hours group had a significantly higher level of propionic acid than the 24-72 hours group at week 4(P<0.05),while there was no significant difference in the total amount of SCFAs and the content of the other SCFAs between the two groups(P>0.05).Conclusions Early enteral feeding has no influence on the diversity and abundance of intestinal flora in VLBW infants,but enteral feeding within 24 hours can increase the level of propionic acid,a metabolite of intestinal flora.

关 键 词：肠内营养 开始时间 肠道菌群 短链脂肪酸 极低出生体重儿 

分 类 号：R722.6[医药卫生—儿科]