食物蛋白诱导的直肠结肠炎患儿不同乳制品喂养前后肠道微生态变化的研究  

Changes in intestinal microecology in children with FPIP before and after feeding with different dairy products

作　　者：崔子鑫 樊迎朝[2] 张新华[2] Cui Zixin;Fan Yingchao;Zhang Xinhua(Department of Pediatric Medicine,Shanxi Medical University,Taiyuan 030000,China;Department of Neonatology,Shanxi Children's Hospital,Taiyuan 030000,China)

机构地区：[1]山西医科大学儿科医学系,山西太原030000 [2]山西省儿童医院新生儿内科,山西太原030000

出　　处：《实用药物与临床》2024年第10期737-743,共7页Practical Pharmacy and Clinical Remedies

基　　金：国家临床重点专科建设项目(新生儿科);山西省儿童医院基金课题(N‑20200601‑1)。

摘　　要：目的探讨3种不同喂养方式对食物蛋白诱导的直肠结肠炎(Food protein-induced proctocolitis,FPIP)患儿喂养前后肠道微生物特点及体格发育的影响。方法以2023年1月至12月山西省儿童医院新生儿内科的60例FPIP患儿作为试验组(失访15例,最终纳入45例),根据家长意愿分为3个亚组:母乳喂养组(母亲回避牛奶、鸡蛋、坚果)(Breastfeeding group,BAM组)、深度水解配方乳喂养组(Extensively hydrolyzed formula group,eHF组)和游离氨基酸配方乳喂养组(Amino acid formula group,AAF组);以本院产科同期分娩、并于后期在儿童保健科定期随访中均未出现FPIP症状的20例健康新生儿作为对照组,采用母乳喂养和/或普通配方乳喂养。比较各组研究对象不同喂养方式前后的临床症状、肠道微生态特点及体格发育情况。结果①实验组3种喂养方式中,AAF组中FPIP患儿腹泻、便血及肉眼血便消失的时间更短,差异有统计学意义(P<0.05)。②治疗前粪便物种丰度AlPha多样性中,试验组的丰富度(Chao1 richness,Chao1)指数和利用稀有物种估算物种多样性(Abundance-based coverage estimator,ACE)指数显著低于对照组,差异有统计学意义(P<0.05)。③治疗后试验组中3组的粪便物种丰度的菌群操作分类单元(Operational taxonmic unit,OTU)及AlPha多样性差异均无统计学意义(P>0.05)。④本研究对肠道菌群的物种差异进行分类学分析,以门水平为例,治疗前试验组较对照组菌群多样性降低,以放线菌门和拟杆菌门降低为主;治疗后试验组3组中,BAM组菌群多样性更接近于对照组,差异无统计学意义(P>0.05);eHF组和AAF组与对照组相比,厚壁菌门和变形菌门占优势,差异有统计学意义(P<0.05)。⑤试验组3组患儿治疗5个月后的体重、身长差异均无统计学意义(P>0.05)。结论游离氨基酸配方乳在治疗FPIP时,临床效果更好;FPIP患儿菌群多样性较健康婴儿降低;母乳喂养(母亲回避牛奶、鸡�Objective To investigate the characteristics of intestinal microorganisms in children with food protein-induced proctocolitis(FPIP)before and after three different feeding methods and their effects on physical development.Methods The 60 FPIP children in the Neonatal Department of Shanxi Children's Hospital from January to December in 2023 were included as the experimental group(15 children were lost in the follow-up and finally 45 were included),and according to their parents'wishes the children were divided into three subgroups:breastfeeding group(mothers avoided cow's milk,eggs and nuts,BAM group),the group fed with extensively hydrolyzed formula(eHF group),and the group fed with amino acid formula(AAF group).Twenty healthy neonates who were born in the same period in the Department of Obstetrics of our hospital and had no FPIP symptoms during regular follow-up in the Department of Child Health Care were selected as the control group,and were fed with breast milk and/or ordinary formula milk.The clinical symptoms,intestinal microecological characteristics and physical development of the subjects in each group before and after different feeding patterns were compared.Results①Among the three feeding methods in the experimental group,the disappearance time of diarrhea,blood in stools and bloody stools with naked eyes was shorter in the children with FPIP in the AAF group,and the difference was statistically significant(P<0.05).②In terms of the pre-treatment fecal species abundance AlPha diversity,the experimental group had a significantly lower abundance(Chao1 richness,Chao1 index)and estimated species diversity using rare species(Abundance-based Coverage Estimator,ACE index)than the control group,the difference being statistically significant(P<0.05).③There was no significant difference in fecal species abundance in the three experimental groups in terms of operational taxonmic unit(OTU)and AlPha diversity after treatment(P>0.05).④In this study,the species differences of intestinal flora were analyzed.At

关 键 词：新生儿 牛奶蛋白过敏 食物蛋白诱导的直肠结肠炎 肠道微生态 体格发育 

分 类 号：R725.7[医药卫生—儿科]