喂养不耐受早产儿肠道菌群的研究

目的 采用实时荧光定量聚合酶链反应（Real-time PCR）技术从微生物生态学的角度分析比较喂养不耐受（feeding intolerance，FI）早产儿与对照组早产儿肠道菌群的变化。方法 以2016年3月至2017年3月于我院儿科新生儿病房确诊的FI早产儿为FI组。选择与FI组胎龄、日龄、出生体重相匹配的非FI早产儿作为对照组。采集出现FI的早产儿和同时段健康早产儿的粪便标本，进行Real-time PCR表达谱分析，比较两组早产儿肠道菌群的差异。结果 临床资料统计分析显示FI组和对照组在性别构成、胎龄、出生体重、生产方式和喂养方式方面差异无统计学意义。Real-time PCR表达谱分析结果显示FI组早产儿肠道大肠埃希菌和肺炎克雷伯菌明显高于对照组，粪肠球菌、乳杆菌和双歧杆菌明显低于对照组。结论 肠道菌群结构的改变参与早产儿FI的发生，该研究结果从微生物学角度为临床儿科医师认识早产儿FI的发生机制和治疗提供了新的思路。

Intestinal microbial change in preterm infants with feeding intolerance

Abstract: Objective To observe and compare the changes of intestinal bacterial community structure in preterm infants with feeding intolerance (FI) and those without FI from the perspective of microecology using real-time polymerase chain reaction. Methods The preterm infants diagnosed as FI during January 2017 and January 2018 in our hospital were included in FI group. The infants without FI but met the inclusion criteria were divided in control group. The stool samples were collected for Real-time PCR analysis, and the diversity and similarity of intestinal bacterial community structure between the two groups were analyzed and compared. Results The numbers of Escherichia coli and Klebsiella pneumonia in FI group were significantly higher, while those of Enterococcus faecalis, Lactobacillus and Bifidobacteria were significantly lower than in control group, respectively. Conclusion The intestinal microbial change may contribute to the development of FI in preterm infants. This research may provide a new idea for clinicians to understand the pathogenesis and treatment of FI in premature infants.