脑瘫儿童营养与免疫因子检测及个体化营养干预效果研究

目的 通过应用人体测量法对脑瘫患儿的营养状况进行评估,并测定体液免疫因子,分析其与营养状况的相关性,为临床实施个体化营养服务提供参考。方法 选择2018年3月-2019年3月在郑州大学第三附属医院儿童康复科住院治疗的1~5岁脑瘫患儿为研究对象,用Z评分法评价患儿的营养状况,并测定其体液免疫因子,通过加强患儿营养治疗干预后,检测患儿各项指标的改善情况。结果 共纳入90例脑瘫患儿进行营养评估并行个体化营养干预,其营养状况不容乐观,营养不良发生率为53.3%(48/90),其中低体重率为33.3%,生长迟缓率为54.2%,消瘦率为20.8%,超重或肥胖率为16.7%;轻、中、重度脑瘫患儿的体重、WAZ、体液免疫因子IgG和IgM差异均有统计学意义(F=3.321、3.964、16.955、5.596,P＜0.05);干预后体重、WAZ高于干预前,差异具有统计学意义(t=2.236、2.280,P＜0.05)。结论 脑瘫患儿营养不良及营养性疾病发生率较高,病情严重程度越重,营养状况越差,体液免疫因子IgG、IgM水平越低。个体化营养干预可改善患儿的近期营养状况。

Detection of nutrition and immune factors in children with cerebral palsy and the effect of individualized nutritional intervention

Objective To evaluate the nutritional status of children with cerebral palsy by anthropometry,and to test the levels of humoral immune factors and analyze the correlation with nutritional status,so as to provide reference for clinical implementation of individualized nutrition services. Methods Children with cerebral palsy aged 1 to 5 years and hospitalized in the Department of Child Rehabilitation of the Third Affiliated Hospital of Zhengzhou University were selected as the study objects. The nutritional status of the children was evaluated by Z-score method,and the levels of humoral immune factors were measured. All children were given nutritional treatment intervention,and the improvement of nutritional indicators was detected after intervention. Results A total of 90 children with cerebral palsy were included for nutritional assessment and were given individualized nutrition intervention. The incidence of malnutrition was 53.3%(48/90),including 33.3% of low weight,54.2% of growth retardation,20.8% of weight loss and 16.7% of overweight or obesity. There were significant differences in weight,WAZ,IgG and IgM levels among children with mild,moderate and severe cerebral palsy (F=3.321,3.964,16.955,5.596, P<0.05). After intervention,the weight and WAZ were higher than those before intervention,and the difference was significant (t=2.236,2.280,P<0.05). Conclusions There is a high prevalence rate of malnutrition and nutritional diseases in children with cerebral palsy. The more serious the disease is,the worse the nutritional status is,and the lower the levels of humoral immune factors IgG and IgM will be. And individualized nutritional intervention plays a positive role in improving recent nutritional status of children with cerebral palsy.