CAJ | 학술논문

目的：分析早产儿1岁内发生变应性疾病的危险因素，评估早产儿不同肠道喂养方式对其外周血嗜酸性粒细胞（EOS）水平和1岁内发生变应性疾病相关性的影响。方法采用回顾性巢式病例对照研究方法。纳入2012年1月至2013年4月上海儿童医学中心新生儿重症监护室收治的人工喂养早产儿为研究队列，随访患儿1岁内出现变应性疾病表现的早产儿作为病例组。把性别作为匹配因素，在队列中未出现变应性疾病表现的早产儿按病例和对照1：2的比例随机抽取对象作为对照组。分析早产儿早期喂养阶段外周静脉血EOS 水平在病例组和对照组中的异同，以及与早期水解牛奶蛋白配方奶（水解配方奶）和普通牛奶蛋白配方奶（普通配方奶）喂养的关系；评估早产儿1岁内发生变应性疾病的危险因素。计数资料采用χ2检验，正态分布计量资料采用 t 检验，非正态分布计量资料采用 Mann-Whitney U 检验，危险因素分析采用多因素条件 Logistic回归模型。结果纳入病例组34例和对照组68例。通过多因素条件 Logistic 回归分析早产儿达到全肠道喂养时外周血 EOS（EOS-2）水平（OR ＝5.941，95% CI：1.165~41.375，P ﹤0.05），家族过敏史（OR ＝3.316，95%CI：1.201~9.152，P ﹤0.05）是早产儿1岁内发生变应性疾病的独立危险因素。普通配方奶组中，EOS-2与1岁内发生过敏疾病的关联性显著增强（OR ＝21.459，95％ CI：1.686~273.152，P ﹤0.05）。与之相比，水解配方奶组中 EOS-2与1岁内发生过敏风险的关联性减弱（OR ＝1.708，95％ CI：0.148~19.743，P ﹥0.05）。结论早产儿生命早期外周血 EOS 水平及家族过敏史是早产儿1岁内发生变应性疾病的危险因素之一。与普通配方奶组相比，水解配方奶组早产儿外周血 EOS 水平与1岁内发生过敏风险的相关性降低，其家族过敏史与1岁内发生过敏风险的相关性也降低。目的：分析早產兒1歲內髮生變應性疾病的危險因素，評估早產兒不同腸道餵養方式對其外週血嗜痠性粒細胞（EOS）水平和1歲內髮生變應性疾病相關性的影響。方法採用迴顧性巢式病例對照研究方法。納入2012年1月至2013年4月上海兒童醫學中心新生兒重癥鑑護室收治的人工餵養早產兒為研究隊列，隨訪患兒1歲內齣現變應性疾病錶現的早產兒作為病例組。把性彆作為匹配因素，在隊列中未齣現變應性疾病錶現的早產兒按病例和對照1：2的比例隨機抽取對象作為對照組。分析早產兒早期餵養階段外週靜脈血EOS 水平在病例組和對照組中的異同，以及與早期水解牛奶蛋白配方奶（水解配方奶）和普通牛奶蛋白配方奶（普通配方奶）餵養的關繫；評估早產兒1歲內髮生變應性疾病的危險因素。計數資料採用χ2檢驗，正態分佈計量資料採用 t 檢驗，非正態分佈計量資料採用 Mann-Whitney U 檢驗，危險因素分析採用多因素條件 Logistic迴歸模型。結果納入病例組34例和對照組68例。通過多因素條件 Logistic 迴歸分析早產兒達到全腸道餵養時外週血 EOS（EOS-2）水平（OR ＝5.941，95% CI：1.165~41.375，P ﹤0.05），傢族過敏史（OR ＝3.316，95%CI：1.201~9.152，P ﹤0.05）是早產兒1歲內髮生變應性疾病的獨立危險因素。普通配方奶組中，EOS-2與1歲內髮生過敏疾病的關聯性顯著增彊（OR ＝21.459，95％ CI：1.686~273.152，P ﹤0.05）。與之相比，水解配方奶組中 EOS-2與1歲內髮生過敏風險的關聯性減弱（OR ＝1.708，95％ CI：0.148~19.743，P ﹥0.05）。結論早產兒生命早期外週血 EOS 水平及傢族過敏史是早產兒1歲內髮生變應性疾病的危險因素之一。與普通配方奶組相比，水解配方奶組早產兒外週血 EOS 水平與1歲內髮生過敏風險的相關性降低，其傢族過敏史與1歲內髮生過敏風險的相關性也降低。
목적：분석조산인1세내발생변응성질병적위험인소，평고조산인불동장도위양방식대기외주혈기산성립세포（EOS）수평화1세내발생변응성질병상관성적영향。방법채용회고성소식병례대조연구방법。납입2012년1월지2013년4월상해인동의학중심신생인중증감호실수치적인공위양조산인위연구대렬，수방환인1세내출현변응성질병표현적조산인작위병례조。파성별작위필배인소，재대렬중미출현변응성질병표현적조산인안병례화대조1：2적비례수궤추취대상작위대조조。분석조산인조기위양계단외주정맥혈EOS 수평재병례조화대조조중적이동，이급여조기수해우내단백배방내（수해배방내）화보통우내단백배방내（보통배방내）위양적관계；평고조산인1세내발생변응성질병적위험인소。계수자료채용χ2검험，정태분포계량자료채용 t 검험，비정태분포계량자료채용 Mann-Whitney U 검험，위험인소분석채용다인소조건 Logistic회귀모형。결과납입병례조34례화대조조68례。통과다인소조건 Logistic 회귀분석조산인체도전장도위양시외주혈 EOS（EOS-2）수평（OR ＝5.941，95% CI：1.165~41.375，P ﹤0.05），가족과민사（OR ＝3.316，95%CI：1.201~9.152，P ﹤0.05）시조산인1세내발생변응성질병적독립위험인소。보통배방내조중，EOS-2여1세내발생과민질병적관련성현저증강（OR ＝21.459，95％ CI：1.686~273.152，P ﹤0.05）。여지상비，수해배방내조중 EOS-2여1세내발생과민풍험적관련성감약（OR ＝1.708，95％ CI：0.148~19.743，P ﹥0.05）。결론조산인생명조기외주혈 EOS 수평급가족과민사시조산인1세내발생변응성질병적위험인소지일。여보통배방내조상비，수해배방내조조산인외주혈 EOS 수평여1세내발생과민풍험적상관성강저，기가족과민사여1세내발생과민풍험적상관성야강저。
Objective To analyze the risk factors associated with allergic disease in preterm infants during the first year of life. To investigate whether there was any association between peripheral blood eosinophils and allergic di-sease during the first year of life benefit of hydrolyzed formula feeding in preterm infants. Methods A nested case -control study was conducted in a cohort of artificial feeding preterm infants admitted to Neonatal Intensive Care Unit, Shanghai Children's Medical Center from January 2012 to April 2013. The preterm infants were monitored from birth up to 1 year of age and the findings were related to development of allergic disease. Individuals with allergic disease during the first year of life(cases)were matched with gender,as previously described with two individuals(controls)who re-mained event - free during the study. The risk factors associated with allergic disease in preterm infants during the first year of life were analyzed. And whether there was any association between peripheral blood eosinophils and allergic di-sease during the first year of life benefit of a hydrolyzed formula feeding in preterm infants was investigated. Different variables in control and case individuals were compared with t test for normal distribution measurement date,χ2 tests for categorical variables and Mann - Whitney U test for non - normal distribution measurement date,and multiple conditio-nal Logistic regression were used to investigate the risk factors associated with allergic disease in preterm infants. Results Thirty - four individuals were in cases and 68 individuals were in controls. In a conditional multivariable Logistic model,peripheral blood eosinophils of preterm infants at full enteral feeding(EOS - 2)(OR = 5. 941,95% CI:1. 165 - 41. 375,P ﹤ 0. 05),and family history of allergy(OR = 3. 316,95% CI:1. 201 - 9. 152,P ﹤ 0. 05)were the two independent risk factors for allergic disease in preterm infants during the first year of life. Individuals fed with standard preterm formula after birth,the association between EOS - 2 and allergic disease was significantly enhanced (OR = 21. 459,95% CI:1. 686 - 273. 152,P ﹤ 0. 05). By contrast,in individuals fed with hydrolyzed formula,the risk of EOS - 2 was substantially attenuated(OR = 1. 708,95% CI:0. 148 - 19. 743,P ﹥ 0. 05). Conclusions Peripheral blood eosinophils of preterm infants at full enteral feeding EOS - 2 and family history of allergy were the 2 independent risk factors for allergic disease in preterm infants during the first year of life. Contrast to individuals fed with standard preterm formula after birth,individuals fed with hydrolyzed formula had lower association between factors of peripheral blood eosinophils and family history of allergy,and allergic disease during the first year of life.