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Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.
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Objective To study the effect of early trace depth hydrolyzed protein formula and infant formula milk on very low birth weight (VLBW) infants of the gastrointestinal tolerance,growth and development,and provide scientific basis for early enteral feeding VLBW.Methods 126 premature infants with birth weight lower than 1 500 g were randomly divided into observation group (63 cases) and control group (63 cases).On the basis of routine treatment,the observation group was given early trace depth hydrolyzed protein formula,the control group was given early minimal preterm formula milk.We oberserved gastrointestinal tolerance,complications and growth monitoring of two groups.Results Period to regain their birth weight,up to full enteral feeding days of age,hospitalization days,discharge rate of extrauterine growth retardation,the incidence of feeding intolerance,the incidence of neonatal necrotizing enterocolitis,feeding dyspeptic diarrhea incidence in observation group were 12.81 d,25.76 d,37.95 d,23.8％,14.3％,6.3％,3.2％.The data in control group were 16.02 d,27.75 d,45.49 d,42.9％,30.2％,19％,12.7％ respectively.There was significant difference between two groups (P ＜ 0.05).Conclusion To carry out early trace depth hydrolysis protein can reduce the risk of the incidence of complications in VLBW infant which has good promotion on the recent growth and suitable for clinical use.
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0.05). The amount of daily body weight gain in early minimal feeding group [(20.8?7.0)g/d] was higher than other groups (P0.05); The incidence of complications (apnea, vomit, abdominal distension, gastrorrhagia) was lower than in gastrogavage group (P0.05). Following all the patients when they were eighteen months old, there was respectively one cerebral palsy in the gastrogavage group and TPN group, and one mental retardation in TPN group. Conclusions Early minimal feeding and early sucking up could reduce the occurrence of feeding complications,shorten the length of hospitalization and reduce the incidence of sequelae in VLBWI.