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[深度水解蛋白配方对早产儿喂养及生长的影响:一项多中心对照临床研究]

[Effects of extensively hydrolyzed protein formula on feeding and growth in preterm infants: a multicenter controlled clinical study].

作者信息

Yu Mu-Xue, Zhuang Si-Qi, Wang Dan-Hua, Zhou Xiao-Yu, Liu Xiao-Hong, Shi Li-Ping, Yue Shao-Jie, Qian Ji-Hong, Sun Jian-Hua

机构信息

Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jul;16(7):684-90.

Abstract

OBJECTIVE

To study the effects of extensively hydrolyzed protein formula (eHF) on the feeding and growth in preterm infants through a multicenter controlled clinical study.

METHODS

Preterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected. They were divided into two observation groups and two control groups. The first observation group consisted of preterm infants with a gestational age of <32 weeks, who were fed with eHF for 10-14 days after birth and then with standard preterm formula (SPF) until discharge. The second observation group consisted of preterm infants with a gestational age of 32-34 weeks, who were fed with SPF after birth, but were switched to eHF (7-14 days) if suffering feeding intolerance at 6-8 days after birth. The two control groups with corresponding gestational ages kept to be fed with SPF after birth. Clinical data were recorded to compare feeding condition, physical growth, blood biochemical indices, and major complications between different groups.

RESULTS

A total of 328 preterm infants were enrolled. Preterm infants with a gestational age of <32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group (P<0.05). They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group (P<0.05). The observation group needed more time in reaching enteral nutrition (EN) basic energy uptake of 50 kcal/(kg·d), partial parenteral nutrition (PPN), hospitalization, and corrected gestational age at discharge compared with the controlled infants (P<0.05). There was no difference in the incidence of extrauterine growth retardation (EUGR) at discharge between the two groups (P>0.05). Preterm infants with a gestational age of 32-34 weeks in the observation group had significantly lower serum total bilirubin levels at 2 weeks after birth compared with the corresponding control group (P<0.05). They required more time in achieving EN basic energy and PPN than in the control group (P<0.05). There was no difference in the incidence of EUGR at discharge between the two groups (P>0.05).

CONCLUSIONS

For preterm infants, eHF can improve gastrointestinal motility, accelerate bilirubin metabolism and excretion and does not increase the incidence of EUGR.

摘要

目的

通过多中心对照临床研究,探讨深度水解蛋白配方奶(eHF)对早产儿喂养及生长的影响。

方法

选取2012年2月至2013年12月在中国8家三级甲等医院住院的早产儿,随机分为两个观察组和两个对照组。第一观察组为孕周<32周的早产儿,出生后10 - 14天喂eHF,之后喂标准早产儿配方奶(SPF)直至出院。第二观察组为孕周32 - 34周的早产儿,出生后喂SPF,但出生后6 - 8天若出现喂养不耐受则换为eHF(7 - 14天)。两个相应孕周的对照组出生后一直喂SPF。记录临床资料,比较不同组间的喂养情况、体格生长、血液生化指标及主要并发症。

结果

共纳入328例早产儿。观察组中孕周<32周的早产儿胎粪排出时间明显短于相应对照组(P<0.05)。出生后1周和2周时,其血清总胆红素水平也明显低于对照组(P<0.05)。与对照婴儿相比,观察组达到肠内营养(EN)基础能量摄入50 kcal/(kg·d)、部分肠外营养(PPN)、住院时间及出院时矫正胎龄所需时间更长(P<0.05)。两组出院时宫外生长发育迟缓(EUGR)发生率无差异(P>0.05)。观察组中孕周32 - 34周的早产儿出生后2周时血清总胆红素水平明显低于相应对照组(P<0.05)。与对照组相比,其达到EN基础能量和PPN所需时间更长(P<0.05)。两组出院时EUGR发生率无差异(P>0.05)。

结论

对于早产儿,eHF可改善胃肠动力,加速胆红素代谢及排泄,且不增加EUGR发生率。

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