低聚果糖在恶性肿瘤患儿肠内营养中的作用

目的评价肠内营养低聚果糖（FOS）配方在恶性肿瘤患儿中的应用价值和前生物效应。方法1999年7月至2001年2月，66例2～12岁恶性肿瘤患儿分FOS组（32例）和．Non-FOS组（34例）进行前瞻性、随机、双盲对照的临床试验。患儿均按标准方案接受化疗并用Nutren Junior FOS或Nutren Junior进行30d的肠内营养支持。分别测定营养支持后第13d及30d的身高、体重、血清白蛋白（ALB）和前白蛋白（PA）等营养指标；C反应蛋白（CRP）、肿瘤坏死因子（TNF）等免疫指标，并计算预期感染营养指数；同时测定粪便中双歧杆菌、乳酸杆菌、肠杆菌及产气荚膜梭菌含量。结果两组治疗期间营养和免疫指标的变化无显著差异。但预期感染及营养指数（PINI）D30时FOS组降低更加明显（P=0．016）。粪便中双歧杆菌含量在FOS组逐步上升，高于Non-FOS组。FOS组乳酸杆菌含量上升，Non-FOS组变化不明显。结论肠内营养含FOS营养配方可提高抗感染能力、促进肠道正常菌群生长，提示其可能具有前生物效应。

The effects of fructo-oligosaccharide in the enteral nutritional support for children with malignant tumors

Objective To investigate the prebiotic effects of fructo oligosaccharide (FOS) in an enteral formula for children with malignant tumors. Methods Sixty six patients (aged from 2 to 12 years) with malignant tumors were recruited between July 1999 and February 2001. A prospective, randomized, double blind and control study was applied to all patients. Thirty two children received Nutren Junior 1.0 supplement with FOS (FOS group) and the other 34 patients with Nutren Junior 1.0 (Non FOS group). The nutritional indexes (body weight and levels of prealbumin and albumin in sera) and immunological indexes (levels of C reactive protein and tumor necrosis factor ( in sera) were recorded at 0, 13 and 30 days after enteral nutritional support. And the prognostic inflammatory and nutritional index (PINI) was also calculated. Moreover, numbers of Bifidobacteria, Lactobacillus, Enterobacteria and Clostridium perfringens were measured in stool.Results Nutritional and immunological parameters did not show significant differences between FOS group and Non FOS group. However, PINI in FOS group was lower than that in Non FOS group ( P = 0.016 ).Stool analysis revealed relatively elevated bifidobacteria count and lactobacillus count for Group Fos on Day 30. Conclusions FOS in enteral formula may have a prebiotic effect in gut physiology.