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目的探讨深度水解蛋白配方奶(e HPF)对极低出生体重(VLBW)早产儿肠系膜上动脉(SMA)血流的影响。方法选择2011年3月至2015年3月我院新生儿重症监护病房收治的VLBW早产儿,随机分为e HPF组及早产儿配方奶喂养组(PF组)。e HPF组以e HPF开奶,喂养至生后14天换PF;PF组直接以PF开奶。彩色多普勒超声检测患儿生后第1、7、14天空腹及第14天餐后30 min SMA血流,进行两组间比较。结果 (1)共纳入64例VLBW早产儿,其中e HPF组30例,PF组34例。e HPF组生后第7天[(41.8±30.3)ml/kg比(21.9±19.2)ml/kg]、第14天[(97.8±43.0)ml/kg比(76.0±39.0)ml/kg]喂养量明显高于PF组,达全肠道喂养时间明显短于PF组[(18.5±9.2)天比(23.0±8.5)天],差异有统计学意义(P<0.05)。(2)两组患儿生后第1、7天空腹状态下SMA收缩期峰流速(PSV)、舒张末期流速(EDV)、时间平均流速(TAMV)、阻力指数(RI)差异均无统计学意义(P>0.05);第14天空腹状态下e HPF组PSV[(95.7±20.9)cm/s比(82.8±20.5)cm/s]、EDV[(19.3±6.6)cm/s比(15.8±6.5)cm/s]、TAMV[(42.3±11.6)cm/s比(36.7±10.4)cm/s]高于PF组,差异有统计学意义(P<0.05)。(3)两组患儿生后第14天餐后30 min SMA PSV、EDV、TAMV均较餐前增高,RI较餐前降低。e HPF组PSV[(115.0±18.3)cm/s比(100.6±23.1)cm/s]、EDV[(29.6±8.1)cm/s比(23.2±7.1)cm/s]、TAMV[(50.0±10.4)cm/s比(42.4±9.8)cm/s]高于PF组,RI[(0.73±0.05)比(0.76±0.05)]低于PF组,差异均有统计学意义(P<0.05)。结论 e HPF喂养可以引起VLBW早产儿SMA血流变化。
Objective To investigate the effect of deep hydrolyzed protein formula (e HPF) on the blood flow of superior mesenteric artery (SMA) in preterm infants with very low birth weight (VLBW). Methods VLBW preterm infants admitted to neonatal intensive care unit in our hospital from March 2011 to March 2015 were randomly divided into e HPF group and preterm infant formula feeding group (PF group). e HPF group e HPF Kai milk, feeding 14 days after birth for PF; PF group directly to PF milk. Color Doppler ultrasonography was used to measure the fasting blood flow on the 1st, 7th, 14th day and the 30th minute after the meal on the 14th day. Results (1) A total of 64 VLBW preterm infants were enrolled, of which 30 were in e HPF group and 34 in PF group. eHF group on day 7 [(41.8 ± 30.3) ml / kg vs (21.9 ± 19.2) ml / kg] and day 14 [(97.8 ± 43.0) ml / kg vs (76.0 ± 39.0) ml / Feeding volume was significantly higher than the PF group, the total intestine feeding time was significantly shorter than the PF group [(18.5 ± 9.2) days than (23.0 ± 8.5) days], the difference was statistically significant (P <0.05). (2) The peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity of flow (TAMV) and resistance index (RI) of SMA in both groups on the 1st and 7th day after birth were not statistically different (P <0.05). On the 14th day, PSV [(95.7 ± 20.9) cm / s vs 82.8 ± 20.5 cm / s] and EDV [(19.3 ± 6.6) cm / s) ± 6.5 cm / s] and TAMV [(42.3 ± 11.6) cm / s vs (36.7 ± 10.4) cm / s] were significantly higher than those in PF group (P <0.05). (3) The SMA PSV, EDV and TAMV in the two groups were all higher than those before meals on the 14th day after birth, and RI was lower than before meals. eVFF [(115.0 ± 18.3) cm / s vs EDV [(29.6 ± 8.1) cm / s vs (23.2 ± 7.1) cm / s] and TAMV [(50.0 ± (P <0.05), and the difference was statistically significant (P <0.05). The difference was statistically significant (P <0.05) . Conclusion e HPF feeding can cause SMA blood flow changes in preterm infants with VLBW.