初乳口腔免疫疗法预防早产儿VAP效果及对NLR、CRP、IL-6水平的影响

doi:10.3969/j.issn.1671-7171.2023.10.030

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摘要【目的】探讨初乳口腔免疫疗法预防早产儿呼吸机相关性肺炎(VAP)效果及对中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平的影响。【方法】回顾性分析2021年4月至2022年4月西电集团医院收治的98例行机械通气的早产儿的临床资料,根据治疗方式的不同将其分为观察组和对照组,每组49例。对照组采用2%碳酸氢钠进行口腔护理,观察组在对照组基础上加用初乳口腔免疫疗法。比较两组患儿机械通气时间、住院时间、出院时头围及体重,比较两组患儿细菌培养情况,比较两组患儿口腔感染、VAP发生率,比较两组患儿治疗后NLR、CRP、IL-6水平。【结果】观察组患儿机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组患儿口咽部分泌物、气管导管分泌物阳性率均低于对照组,差异有统计学意义(P<0.05)。观察组患儿口腔感染、VAP总发生率低于对照组,差异有统计学意义(P<0.05)。观察组患儿治疗后NLR、CRP、IL-6水平均显著低于对照组,差异有统计学意义(P<0.05)。【结论】初乳口腔免疫疗法能够有效预防早产儿VAP的发生,降低患儿血清NLR、CRP、IL-6水平,调节患儿免疫功能。

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	李静
	郭小霞
	蔡玮

关键词 ：婴儿, 早产, 连续气道正压通气, 肺炎, 呼吸机相关性, C反应蛋白质, 白细胞介素6

Abstract：【Objective】To investigate the effect of colostrum oral immunotherapy in preventing ventilator-associated pneumonia (VAP) in premature infants and its influence on serum levels of neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and interleukin-6 (IL-6). 【Methods】A retrospective analysis was conducted on the clinical data of 98 premature infants who underwent mechanical ventilation from April 2021 to April 2022 in the Xidian Group Hospital. They were divided into an observation group and a control group according to different treatment methods, with 49 patients in each group. The control group received oral care with 2% sodium bicarbonate, while the observation group received colostrum oral immunotherapy in addition to the treatment for the control group. The mechanical ventilation time, hospitalization time, head circumference at discharge, and weight were compared between the two groups of children. The bacterial culture results were compared between the two groups of children. The incidences of oral infection and VAP were compared between the two groups of children. Serum levels of NLR, CRP, and IL-6 were compared between the two groups of children after treatment.【Results】 The mechanical ventilation time and hospitalization time in the observation group were significantly less than those in the control group (P<0.05). The positive rates of pharyngeal secretions and tracheal aspirate secretions in the observation group were significantly lower than those in the control group (P<0.05). The total incidence of oral infection and VAP in the observation group was significantly lower than that in the control group (P<0.05). Serum levels of NLR, CRP, and IL-6 after treatment in the observation group were significantly lower than those in the control group (P<0.05). 【Conclusion】 Colostrum oral immunotherapy can effectively prevent the occurrence of VAP in premature infants, reduce serum levels of NLR, CRP, and IL-6, and regulate immune function.

Key words： Infant, Premature Continuous Positive Airway Pressure Pneumonia, Ventilator-Associated C-Reactive Protein Interleukin-6

收稿日期: 2022-10-06

中图分类号:

R722.6

通讯作者: *E-mail:lj_3730@163.com

引用本文:

李静, 郭小霞, 蔡玮. 初乳口腔免疫疗法预防早产儿VAP效果及对NLR、CRP、IL-6水平的影响[J]. 医学临床研究, 2023, 40(10): 1547-1550.
LI Jing, GUO Xiaoxia, CAI Wei. The Effect of Colostrum Oral Immunotherapy on Preventing Ventilator-associated Pneumonia in Premature Infants and its Influence on Serum Levels of NLR, CRP, and IL-6. JOURNAL OF CLINICAL RESEARCH, 2023, 40(10): 1547-1550.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.10.030 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I10/1547

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