Vásquez-Garibay Edgar, Méndez-Estrada Concepción, Romero-Velarde Enrique, García-Iglesias Ma Trinidad, Campollo-Rivas Octavio
Instituto de Nutrición Humana, Departamento de Reproducción Humana, Crecimiento y Desarrollo Infantil, 44340 Guadalajara, Jalisco, Mexico.
Arch Med Res. 2004 Jul-Aug;35(4):284-8. doi: 10.1016/j.arcmed.2004.03.002.
Adequate nutritional support of severe primary protein energy malnutrition (PEM) is indispensable for achieving normal immune response. However, an ideal dietetic criterion has not yet been established or accepted by the majority of health professionals caring for malnourished infants. Our objective was to demonstrate improvement in immune response in infants with PEM who received starting infant formula with nucleotides.
Twelve malnourished infants 3-18 months of age were included in our study and were fed through a nasogastric tube with infant formula (3.35 kJ/mL) for 2 weeks and ad libitum for an additional 2 weeks. Anthropometric measurements and immunologic indicators such as phagocytosis, microbicidal activity, chemotaxis, and cell proliferation index were determined. The sample was divided into two groups; group 1 (n=6) was fed formula with nucleotides added, while group 2 (n=6) was fed a formula with no nucleotides. Paired t test was used to determine differences between initial and final results for each group for comparison between group 1 vs. group 2; a nonparametric Mann-Whitney U test was used for immunologic indicators.
Comparison of immunologic indicators showed no significant difference between groups. Groups 1 and 2 showed improvement in phagocytosis and microbicidal activity (p <0.05) and group 2 additionally showed improvement in cell proliferation index.
Infant formula with intake of 837 kJ/kg/d (200 kcal/kg/d) and proteins of 4 g/kg/d in infants with PEM had a favorable impact on immunologic indicators regardless of addition of nucleotides.
对于严重的原发性蛋白质能量营养不良（PEM），充足的营养支持对于实现正常免疫反应必不可少。然而，目前尚未建立理想的饮食标准，也未被大多数照料营养不良婴儿的健康专业人员所接受。我们的目的是证明接受含核苷酸起始婴儿配方奶粉的PEM婴儿的免疫反应有所改善。
12名3至18个月大的营养不良婴儿纳入我们的研究，通过鼻胃管喂食婴儿配方奶粉（3.35 kJ/mL）2周，之后随意喂食2周。测定人体测量指标和免疫指标，如吞噬作用、杀菌活性、趋化性和细胞增殖指数。样本分为两组；第1组（n = 6）喂食添加核苷酸的配方奶粉，而第2组（n = 6）喂食不含核苷酸的配方奶粉。采用配对t检验确定每组初始和最终结果之间的差异，以比较第1组和第2组；免疫指标采用非参数曼-惠特尼U检验。
免疫指标比较显示两组之间无显著差异。第1组和第2组的吞噬作用和杀菌活性均有改善（p <0.05），第2组的细胞增殖指数也有改善。
对于PEM婴儿，摄入837 kJ/kg/d（200 kcal/kg/d）且蛋白质含量为4 g/kg/d的婴儿配方奶粉，无论是否添加核苷酸，对免疫指标都有有利影响。
