本文選題：益生菌 + 嬰兒��； 參考：《河北醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：母乳喂養(yǎng)是嬰兒時(shí)期營(yíng)養(yǎng)來(lái)源的首要選擇，但是并非每個(gè)嬰兒都能享受母乳的益處，如何解決不能接受母乳喂養(yǎng)嬰兒或母乳喂養(yǎng)不足嬰兒的營(yíng)養(yǎng)支持問(wèn)題成為兒童生長(zhǎng)發(fā)育與疾病研究的一個(gè)前沿課題。益生菌是活的非致病性微生物，定居于宿主腸道，可以調(diào)節(jié)腸道菌群及其代謝活動(dòng)，對(duì)機(jī)體產(chǎn)生有益作用。生命早期配方奶中添加益生菌對(duì)嬰兒生長(zhǎng)發(fā)育和疾病的影響目前尚無(wú)國(guó)內(nèi)報(bào)道。本研究旨在通過(guò)觀察生命早期含有益生菌的配方奶喂養(yǎng)嬰兒嘔吐，煩躁哭鬧，大便頻率及稠厚度等指標(biāo)，測(cè)量不同月齡嬰兒身高，體重，頭圍，胸圍和皮下脂肪厚度(subcutaneous fatthickness, SFT)，觀察不同喂養(yǎng)方式下嬰兒呼吸道感染與感染性腹瀉的發(fā)病率，并測(cè)定嬰兒糞便中雙歧桿菌(bifidobacteria)數(shù)量，了解添加益生菌配方奶的嬰幼兒耐受情況，及生命早期益生菌干預(yù)對(duì)嬰兒生長(zhǎng)發(fā)育的影響、預(yù)防感染性疾病中的作用及不同喂養(yǎng)方式下雙歧桿菌在腸道中的定植情況，為生命早期添加益生菌對(duì)今后健康發(fā)展的作用提供理論及臨床依據(jù)。 方法：選擇2011年11月-2012年9月在河北醫(yī)科大學(xué)第三醫(yī)院和石家莊市第四人民醫(yī)院出生的新生兒120例，其中男65例，女55例。由益生菌配方奶喂養(yǎng)的嬰兒60例，男32例、女28例，其中15例在隨訪過(guò)程中因依從性差或其他原因而脫落，故實(shí)際例數(shù)為45例，男25例，女20例；由普通配方奶喂養(yǎng)的嬰兒60例，，男31例，女29例，其中12例在隨訪過(guò)程中因依從性差或其他原因而脫落，故實(shí)際例數(shù)48例，男25例，女23例；同期選擇兩地生后母乳喂養(yǎng)的嬰兒60例，男33例，女27例，其中18例在隨訪過(guò)程中因依從性差其他原因退組，故實(shí)際例數(shù)為42例，男23例，女19例。各組嬰兒及其雙親均生活在石家莊市或其周邊縣市，氣候環(huán)境，居住環(huán)境，飲食環(huán)境等相當(dāng)。各組嬰兒出生體重、身長(zhǎng)、頭圍、胸圍、性別、皮下脂肪厚度、胎齡和脫落率之間無(wú)差異。所有入選對(duì)象均在研究開(kāi)始前簽訂知情同意書(shū)，并獲河北醫(yī)科大學(xué)第三醫(yī)院倫理道德委員會(huì)同意。本研究分兩部分進(jìn)行：臨床指標(biāo)觀察及測(cè)量：隨訪觀察添加益生菌配方奶喂養(yǎng)兒、普通配方奶喂養(yǎng)兒及母乳喂養(yǎng)兒6個(gè)月內(nèi)大便頻率及稠厚度、嘔吐，煩躁哭鬧等指標(biāo)，了解添加益生菌配方奶喂養(yǎng)兒的耐受情況；通過(guò)測(cè)量出生第1天、第1個(gè)月、第2個(gè)月、第3個(gè)月、第4個(gè)月、第5個(gè)月和第6個(gè)月齡時(shí)嬰兒的身高，體重，頭圍，胸圍和皮脂厚度等指標(biāo)，了解不同喂養(yǎng)方式下嬰兒生長(zhǎng)發(fā)育狀況；觀察不同喂養(yǎng)方式下嬰兒呼吸道感染與感染性腹瀉的發(fā)生率，了解益生菌在預(yù)防感染性疾病中的作用。實(shí)驗(yàn)室檢測(cè)：收集新生兒生后第7天、1個(gè)月、3個(gè)月、6個(gè)月齡時(shí)糞便標(biāo)本，采用熒光定量聚合酶鏈?zhǔn)椒磻?yīng)(Flurogenic Quantitative Polym-erase Chain Reaction,FQ-PCR)技術(shù)測(cè)定糞便中雙歧桿菌(bifidobacteria)數(shù)量，了解不同喂養(yǎng)方式下腸道雙歧桿菌在腸道中的定植情況。統(tǒng)計(jì)分析采用SPSS13.0軟件。 結(jié)果： 1益生菌喂養(yǎng)兒、普通奶粉喂養(yǎng)兒及母乳喂養(yǎng)兒之間性別、胎齡、體重、身長(zhǎng)、頭圍、胸圍、皮下脂肪厚度和脫落率無(wú)差異(P均0.05); 2益生菌喂養(yǎng)兒、普通配方奶喂養(yǎng)兒及母乳喂養(yǎng)兒三組之間大便頻率、稠厚度、嘔吐及煩躁哭鬧均無(wú)差異(P均0.05)； 3益生菌喂養(yǎng)兒和母乳喂養(yǎng)兒身高和體重在第3個(gè)月、4個(gè)月、5個(gè)月、6個(gè)月齡時(shí)較普通奶粉喂養(yǎng)組高(P0.05)；益生菌喂養(yǎng)兒和母乳維喂養(yǎng)兒在第3個(gè)月、4個(gè)月、5個(gè)月和6個(gè)月齡時(shí)身長(zhǎng)和體重?zé)o差異(P均0.05)。益生菌喂養(yǎng)兒、普通配方奶喂養(yǎng)兒和母乳喂養(yǎng)兒在第1-6個(gè)月齡時(shí)的頭圍、胸圍和皮脂厚度比較均無(wú)差異(P均0.05)。益生菌喂養(yǎng)兒、普通配方奶喂養(yǎng)兒和母乳喂養(yǎng)兒在第1個(gè)月和2個(gè)月齡時(shí)的身長(zhǎng)、體重?zé)o差異(P0.05); 4益生菌喂養(yǎng)兒、普通配方奶喂養(yǎng)兒和母乳喂養(yǎng)兒在3個(gè)月內(nèi)呼吸道感染和感染性腹瀉發(fā)病率無(wú)差異(P0.05)；但益生菌喂養(yǎng)兒和母乳喂養(yǎng)兒在6個(gè)月內(nèi)感染性腹瀉的發(fā)病率低于普通奶粉喂養(yǎng)兒（P0.05）；益生菌喂養(yǎng)兒和母乳喂養(yǎng)兒在6個(gè)月內(nèi)感染性腹瀉的發(fā)病率無(wú)差異(P0.05)； 5母乳喂養(yǎng)組嬰兒在生后第1個(gè)月、3個(gè)月和6個(gè)月齡時(shí)糞便雙歧桿菌數(shù)量高于普通配方奶喂養(yǎng)組嬰兒，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；益生菌喂養(yǎng)組嬰兒在生后第1個(gè)月、3個(gè)月和6個(gè)月時(shí)糞便雙歧桿菌數(shù)量高于普通奶粉喂養(yǎng)組嬰兒，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；益生菌喂養(yǎng)組嬰兒在生后第6個(gè)月時(shí)糞便雙歧桿菌數(shù)量高于母乳喂養(yǎng)組嬰兒，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；益生菌喂養(yǎng)組、普通奶粉喂養(yǎng)組和母乳喂養(yǎng)組嬰兒在生后第7天時(shí)糞便雙歧桿菌數(shù)量比較無(wú)差異（P0.05）；益生菌喂養(yǎng)組與母乳喂養(yǎng)組嬰兒在生后第1個(gè)月和3個(gè)月時(shí)糞便雙歧桿菌數(shù)量比較無(wú)統(tǒng)計(jì)學(xué)差異（P0.05）。 結(jié)論：生命早期添加雙歧桿菌嬰兒耐受良好，未發(fā)現(xiàn)任何不良反應(yīng)。生后早期雙歧桿菌干預(yù)可以增加腸道中雙歧桿菌的定植，促進(jìn)腸道粘膜的成熟和發(fā)育，改善腸內(nèi)微生態(tài)環(huán)境，利于其他有益菌的定植，更好的修飾腸道菌群結(jié)構(gòu)；生命早期添加雙歧桿菌能夠促進(jìn)嬰兒的生長(zhǎng)發(fā)育，表現(xiàn)反映在體重和身高的增加，對(duì)胸圍、頭圍和皮下脂肪的增長(zhǎng)效應(yīng)不顯著；生命早期添加益生菌能夠降低生后6個(gè)月內(nèi)嬰兒感染性疾病尤其是感染性腹瀉的發(fā)生率。
[Abstract]:Objective: breastfeeding is the primary choice for infant nutrition, but not every baby can enjoy the benefits of breast milk. How to solve the problem of nutritional support that can not be breastfed or breastfeeding babies is a leading issue in the study of children's growth and disease. Probiotics are the living non pathogenic factors. Microbes, settled in the gut of the host, can regulate the intestinal flora and its metabolic activities and have a beneficial effect on the body. There is no domestic report on the effects of probiotics on the growth and disease of infants at the early stage of life. This study aims to feed infant vomiting and irritability by observing the early probiotic formula in the early life. To observe the height, weight, head circumference, chest circumference and subcutaneous fat thickness (subcutaneous fatthickness, SFT) of infants of different months of age, to observe the incidence of respiratory infection and infective diarrhea in infants under different feeding methods, and to determine the number of Bifidobacterium (bifidobacteria) in infant feces and to understand the added benefits. The tolerance of infant formula milk, the effect of probiotic intervention on the growth and development of infants in the early life, the role of preventing infectious diseases and the colonization of Bifidobacterium in the intestine under different feeding ways, provide theoretical and clinical basis for the role of probiotics in the early life for the future healthy development.
Methods: 120 newborns born in Third Hospital of Hebei Medical University and fourth people's Hospital of Shijiazhuang in September -2012 in November 2011 were selected, including 65 males and 55 females. 60 cases, 32 men and 28 women were fed by probiotic formula milk, of which 15 cases fell off due to poor compliance or other reasons in the follow-up process, so the actual number of cases was counted. There were 45 cases, 25 males and 20 females, 60 infants, 31 men and 29 women, among which 12 cases were dropped from poor compliance or other reasons in the follow-up process, so there were 48 cases, 25 men and 23 women, and 60, male 33, and 27 cases were chosen in the same period. The number of actual cases was 42 cases, 23 males and 19 females. All the infants and their parents lived in Shijiazhuang or its surrounding counties and cities. The climatic environment, the living environment, the diet environment, etc. were equal. There was no difference between the birth weight, the length, the head circumference, the chest circumference, the sex, the thickness of the subcutaneous fat, the fetal age and the rate of fall. Informed consent was signed before the start of the study and agreed by the ethics committee of the Third Hospital of Hebei Medical University. The study was divided into two parts: observation and measurement of clinical indicators: follow-up observation added probiotic formula feeding children, regular formula milk feeding children and breast-feeding children's stool frequency and consistency within 6 months. To understand the tolerance of supplemented probiotic formula feeding infants, and to understand the height, weight, head circumference, chest circumference and sebum thickness of infants at first days of birth, first months, second months, third months, fourth months, fifth months and sixth months, to understand the growth and development of infants under different feeding methods. To observe the incidence of infantile respiratory infection and infective diarrhea under different feeding methods and to understand the role of probiotics in the prevention of infectious diseases. Laboratory test: collection of fecal specimens at seventh days, 1 months, 3 months and 6 months of age after birth of newborn infants, using Flurogenic Quantitative Polym- by fluorescence quantitative polymerase chain reaction. Erase Chain Reaction, FQ-PCR) technique was used to determine the number of Bifidobacterium (bifidobacteria) in feces, and to understand the colonization of Bifidobacterium in intestinal tract under different feeding methods. The statistical analysis was carried out by SPSS13.0 software.
Result錛

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