Department of Neonatology, Center for Pediatric Clinical Studies, University Children's Hospital, Tuebingen, Germany.
Arch Dis Child Fetal Neonatal Ed. 2018 Sep;103(5):F485-F489. doi: 10.1136/archdischild-2017-313278. Epub 2017 Nov 9.
To evaluate the effects of pancreatic enzyme substitution (PES) in selected very low birthweight (VLBW) infants with poor postnatal growth despite intensified nutritional support.
Retrospective historic cohort study with matched controls.
Single level III neonatal intensive care unit.
Infants with a gestational age at birth <32 weeks and birth weight <1500 g born between 1 January 2005 and 31 December 2014 (n=26) who received PES for restricted postnatal growth despite intensified enteral nutritional support in comparison with infants matched for birth weight, birth year, gestational and postnatal age (n=52).
PES 15-93 mg/g fat with enteral feeds.
The difference in SD score (SDS) differences for weight during the 7 days before and after onset of PES and weight gain in g/kg/d. Data are presented as median (P10-P90).
Gestational age was 26.6 (24.4-29.9) weeks in enzyme substituted versus 26.4 (24.7-29.9) weeks in matched controls, and birth weight was 648(420-950)g versus 685(453-949)g. SDS differences for weight improved after onset of PES by 0.18(-0.12 to 0.53) in PES infants versus -0.04(-0.31 to 0.44) in controls. Weight gain increased in the PES group from 13.6 (4.2-22.9) g/kg/day in the week before to 19.0 (10.9-29.1) g/kg/day in the week after the onset of PES. There was no difference in weight gain in substituted subgroups receiving formula/pasteurised human milk versus unpasteurised human breast milk or who had pancreatic-specific elastase-1 concentrations in stool >200 µg/g versus≤200 µg/g. No adverse effects were noted.
PES in selected VLBW infants with growth failure despite intensified enteral nutritional support was associated with a significant increase in weight gain in the first 7 days of PES.k.
评估在强化营养支持下仍出现生长不良的特定极低出生体重（VLBW）婴儿中使用胰酶替代治疗（PES）的效果。
回顾性历史队列研究，设有匹配对照组。
单级 3 级新生儿重症监护病房。
2005 年 1 月 1 日至 2014 年 12 月 31 日出生的胎龄<32 周、出生体重<1500g 的婴儿（n=26），尽管接受了强化肠内营养支持，但仍存在生长受限，将其与根据出生体重、出生年份、胎龄和生后年龄匹配的婴儿（n=52）进行比较。
PES 15-93mg/g 脂肪与肠内喂养联合使用。
PES 开始前 7 天和开始后 7 天体重的标准差评分（SDS）差异和体重增长率（g/kg/d）。数据以中位数（P10-P90）表示。
PES 组的胎龄为 26.6（24.4-29.9）周，匹配对照组为 26.4（24.7-29.9）周，出生体重为 648（420-950）g 和 685（453-949）g。PES 组体重 SDS 差值在 PES 开始后改善 0.18（-0.12 至 0.53），而对照组则为-0.04（-0.31 至 0.44）。PES 组体重增长率在 PES 开始前为 13.6（4.2-22.9）g/kg/d，在 PES 开始后为 19.0（10.9-29.1）g/kg/d。在接受配方/巴氏消毒人乳与未巴氏消毒人母乳、粪便中胰酶特异性弹性蛋白酶-1 浓度>200μg/g 与≤200μg/g 的替代亚组之间，体重增长率没有差异。未观察到不良事件。
在强化肠内营养支持下仍出现生长不良的特定 VLBW 婴儿中使用 PES 治疗与 PES 开始后 7 天内体重显著增加相关。
