目的 探讨乳铁蛋白对34~36周早产儿贫血及反复呼吸道感染的影响.方法 将80例广西妇幼保健院儿童保健科门诊随访跟踪的34~36周的早产儿随机分为2组,对照组于1月龄开始服用右旋糖酐铁分散片治疗,治疗组同期使用乳铁蛋白胶囊,至矫正年龄1岁时观察两组早产儿反复呼吸道感染的发生率,抗生素使用率及感染后住院率并监测治疗前后血红蛋白(Hb)、红细胞压积(Rct)、铁蛋白、血清铁及T细胞亚群、免疫球蛋白的变化.结果 治疗后两组间的Hb及Rct差异均无统计学意义(t值分别为1.78、0.75,均P>0.05),但治疗组的血清铁蛋白(40.61±3.12ng/mL)及血清铁(12.34±2.11μmol/L)均明显高于对照组(t值分别为2.51、2.06,均P<0.05);同时与对照组相比,治疗组免疫学指标CD4、CD8、T杀伤细胞(NK)细胞、总T淋巴细胞亚群及血清IgA均较治疗前明显升高(t值分别为4.73、4.22、7.04、2.92、3.95,均P<0.05),且反复呼吸道感染发生率(20%),抗生素使用率(17.5%)及感染后住院率(12.5%)均低于对照组(χ2值分别为4.71、4.01、4.58,均P<0.05).结论 乳铁蛋白能有效预防晚期早产儿贫血,且能降低晚期早产儿反复呼吸道感染发生率及感染后住院率,减少抗生素使用,提高免疫功能.%Objective To explore effect of the lactoferrin on anemia and recurrent respiratory tract infection in preterm infants born between 34 to 36 weeks.Methods A total of 80 cases of preterm infants born between 34 to 36 weeks, whose outcomes were followed up, were randomly divided into two groups.All those preterm infants received treatment at child health clinic of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region.Infants in control group started to take iron dextran dispersible tablets when they were one month old.At the same time, infants in treatment group received lactoferrin capsules.When all the infants were at 1 year corrected age, incidence rate of recurrent respiratory tract infection, the usage of antibiotics, and post-infectious hospitalization rate in infants of both groups were calculated. In addition, changes in hemoglobin (Hb) , hematocrit (Hct) , ferritin, serum iron, T cell subest and immunoglobulin were monitored before and after treatment.Results There was no statistically significant difference in Hb and Hct between two groups after treatment (t value was 1.78 and 0.75, respectively, both P>0.05).However, the levels of ferritin (40.61 ±3.12 ng/mL) and serum iron (12.34 ±2.11μmol/L) were significantly higher in the treatment group than in the control group (t value was 2.51 and 2.06, respectively, both P<0.05).Compared with the control group, the treatment group witnessed more significant increase in CD4, CD8, NK cells, T lymphocyte subsets and serum IgA (t value was 4.73, 4.22, 7.04, 2.92 and 3.95, respectively, all P<0.05).Moreover, the incidence rate of recurrent respiratory tract infection (20%), usage of antibiotics (17.5%) and post-infectious hospitalization rate (12.5%) were lower in the treatment group than in the control group (χ2 value was 4.71, 4.01 and 4.58, respectively, all P<0.05).Conclusion Lactoferrin can effectively prevent late preterm infants from anemia and reduce the incidence rate of recurrent respiratory tract infection and post-infectious hospitalization rate.In addition, lactoferrin can help to reduce the usage of antibiotics and strengthen immunologic functions.
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