母乳胃动素和胃泌素浓度测定及其意义

本文测定了45例正常产妇的血及初乳中胃动素和胃泌素浓度,结果发现,母乳胃动素(206.53±110.42ngL)和胃泌素浓度(150.42±58.00ng/L)均达到母血胃动素(443.05±40.79ng/L)和胃泌素浓度(301.32±100.98ng/L)的二分之一水平。提示母乳可为新生儿提供一定数量的胃动素和胃泌素。本文对乳汁中胃动素和胃泌素进入新生儿体内的作用进行了初步讨论。     

母乳喂养与代乳品喂养新生儿血中胃泌素及胃动素水平比较

目的比较正常新生儿母乳喂养与代乳品喂养情况下血中胃泌素及胃动素水平的差异。方法应用放射免疫分析技术对100例正常足月新生儿(其中比较组50例由母乳喂养．对照组50例由代乳品喂养)的血清胃泌素、血浆胃动素进行了检测和统计分析。结果比较组胃泌素和胃动素水平明显高于对照组．表明母乳中胃泌素、胃动素进入新生儿体内后与内源性胃泌素、胃动素具有类似的生物活性．能补充新生儿体内的不足。结论从胃肠激素这一角度证明母乳喂养的优越性。     

窒息后新生儿血中胃泌素和胃动素水平变化及相关因素探讨

目的探讨新生儿窒息后血中胃泌素、胃动素的变化及临床意义,以及促使其恢复的可能相关因素。方法将100例窒息新生儿分为轻度窒息组及重度窒息组,其中重度窒息组随机分为禁食组(A)与微量喂养联合非营养性吸吮组(B),用放射免疫法对出生后第1日喂奶前及第5日空腹血中胃泌素、胃动素浓度进行了测定,与正常新生儿作对照。结果①轻度窒息组生后第1日血中胃泌素、胃动素与对照组比较无显著性意义(P>0.05)。②重度窒息组生后第1日血中胃泌素、胃动素水平则明显低于对照组,有显著性意义(P<0.01);生后第5日空腹血中胃泌素、胃动素浓度均较生后第1日喂奶前升高(P<0.05);其中A组仍低于同期对照组水平(P<0.05),B组其水平较A组明显升高(P<0.01),与同期对照组无显著性差异(P>0.05)。结论①轻度窒息新生儿生后第1日新生儿血中胃泌素、胃动素的水平基本同正常新生儿,提示可酌情给予早期胃肠营养。②重度窒息新生儿生后第1日血中胃泌素、胃动素的水平明显降低,微量喂养联合非营养性吸吮可缩短两种激素水平恢复时间。     

新生儿窒息血胃动素和胃泌素水平的相关性研究

[目的]探讨新生儿窒息患儿血胃动素（motilin,MTL）和胃泌素（gastric acid secretion,GAS）水平,及其与病程、病情及预后的关系.[方法]应用放射免疫分析法（RIA）测定67例窒息新生儿病程2d内、3～5d、7～10d、12～15d血MTL和GAS的水平,并与正常对照组比较.[结果]新生儿窒息患儿以出生2d内血浆MTL和血清GAS水平最高,随病程延长而逐步降低;轻度窒息患儿7～10d恢复正常;重度窒息患儿12～15d与正常对照组比较差异仍有显著性.根据临床表现将新生儿窒息组分为4个观察组,将血MTL和GAS水平的动态变化与正常对照组和其阴性对照组比较,均有统计学意义.[结论]血MTL和GAS水平与新生儿窒息患儿病程、病情密切相关,对预后判断有重要意义,亦能为临床治疗提供参考.     

危重病新生儿血清胃泌素、胃动素变化的临床意义

[目的] 探讨危重病新生儿血清胃泌素、胃动素浓度水平的变化及临床意义。[方法] 采用放射免疫方法检测120例患病新生儿和60例正常新生儿血清胃泌素和血浆胃动素及治疗一周后危重病新生儿的血清胃泌素和胃动素浓度。[结果] 患病新生儿血清胃泌素、血浆胃动素均较正常对照组低(P＜0．01)；危重儿明显低于非危重儿及对照组(P＜0．01)。[结论] 新生儿血清胃泌素和胃动素的分泌程度与病情的严重程度有一定相关性，即病情越重，浓度越低。     

不同喂养方式早产儿血胃动素、胃泌素及胃蛋白酶原浓度变化的研究

目的 动态监测早产儿开奶前、生后第3天、第7天及第14天血中胃动素、胃泌素及胃蛋白酶原的浓度变化,并予以三种不同的喂养方式干预,探讨早产儿血胃动素、胃泌素及胃蛋白酶原的动态变化及其与喂养方式的相关性,探讨合理的喂养方式.方法 需经间断鼻胃管喂养的胎龄34周以下的早产儿52例,随机分为三组,分别予以不同的喂养方式.放射免疫法批量监测血胃动素、胃泌素及胃蛋白酶原的水平.结果 （1）开奶前三组胃动素、胃泌素及胃蛋白酶原水平无明显差异,随喂养时间延长,非营养性吸吮组、滴服喂养组均高于单纯鼻胃管喂养组.非营养性吸吮组较明显,差异有显著意义.（2）早产儿血胃蛋白酶原的浓度变化与胃动素及胃泌素水平成正相关.（3）非营养性吸吮及滴服喂养组喂养不耐受的发生率减低,达全口喂养时间、黄疸持续时间及住院时间缩短.非营养性吸吮组更为明显.结论 早产儿血胃蛋白酶原的浓度变化与胃动素及胃泌素水平成正相关 非营养性吸吮及滴服喂养均可促进胃动素及胃泌素和胃蛋白酶原的分泌,促进胃肠功能的成熟,而非营养性吸吮作用更为明显.     

新生儿缺氧缺血性脑损伤血胃动素和促胃液素水平的相关性研究

目的 探讨新生儿缺氧缺血性脑损伤（HIBD）对胃肠激素分泌的影响及其相关性的意义。方法 应用放射免疫分析法（RIA）测定67例新生儿窒息患儿（包括45例HIBD患儿和22例非HIBD患儿），病程2d内，3d～5d，7d～10d，12d～15d血浆胃动素（MTL）和血清促胃液素（GAS）的含量。据临床表现，将HIBD组分为3个观察组，将血MTL和GAS水平的动态变化与其阴性对照组比较，并对其数据进行统计学处理。结果①HIBD患儿在整个病程中，血MTL和GAS升高明显（P＜0．05）。②非HIBD新生儿血MTL和GAS与对照组比较，差异无显著意义（P＞0．05）。③伴有惊厥、胃肠功能降低、持续的胃肠喂养困难，血MTL和GAS水平升高明显，并较其他组下降缓慢。结论 HIBD患儿存在血MTL和GAS分泌异常，血MTL和GAS水平与脑损伤的程度、胃肠功能及病情的恢复密切相关。     

小儿腹泻病血胃泌素、胃动素和生长抑素含量变化与胃肠运动功能的关系

目的：探讨小儿迁延性及慢性腹泻病血中胃泌素（GAS），胃动素（MOT）和生长抑素（SS）的变化情况和它们与胃肠动力紊乱的关系。方法：应用放免法对28例迁延性及慢性腹泻病患儿治疗前和恢复期晨空腹及餐后1小时的血GAS，MOT和SS水平进行测定，并用实时超声显像法对他们餐后的胃运动及胃排空进行研究，同时与22例正常儿童作比较。结果：患儿治疗前空乃和餐后的血清GAS和血浆MOT水平高于恢复期和对照组（P＜0．001），空腹的血浆SS水平尽管前者亦高于后两者（P＜0．05），但餐后差异无显著性（P＞0．05），患儿治疗前空腹和餐后的GAS／SS和MOT／SS比值明显大于恢复期和正常儿童（P＜0．05），患儿病期的胃体蠕动频率（FB），胃窦收缩频率（FA）和30，60，90，及120分钟胃排空率（GER）明显增快，而且120分钟GER与空腹和餐后的血浆SSI 各组都呈负相关，与GAS／SS和MOT／SS的比值则呈正相关。结论：迁延性及慢性腹泻小儿血中的GAS和MOT水平升高，GAS／SS和MOT／SS比值增大，而且GAS，MOT和SS分泌失调与胃肠动力异常有密切的关系。     

慢性乙型肝炎患者血浆内毒素、胃泌素、胃动素的关系及临床意义

肝脏是激素内稳态的重要平衡器官,多种激素在肝脏产生和灭活,当肝脏功能受损时,体内激素水平平衡状态被破坏,继而产生相应的临床症状。慢性乙型肝炎是引起我国肝纤维化和肝硬化的主要原因,内毒素血症在肝纤维化、肝硬化     

胃液胃动素测定及其临床意义

胃动素(motilin,MTL)是一种与消化道运动有关的多肽激素.通过血液MTL浓度的观察,已阐明了MTL与消化过程及某些消化道疾病有密切关系.为研究胃液中MTL浓度对疾病的诊断意义,我们观察了浅表性胃炎、胃溃疡、十二指肠溃疡、萎缩性胃炎、胃癌等患者胃液中胃动素浓度.同时测定胃液中癌胚抗原(carcino-embryonic antigen,CEA)浓度,探讨了它们与消化道疾病的关系及临床诊断价值.     

Motilin and Gastrin Secretion and Lipid Profile in Preterm Neonates Following Prebiotics Supplementation

Background: Gut hormones play an important role in the adaptation of the immature neonatal gut, and their secretion may be modulated by prebiotics. Furthermore, prebiotics are well known for their hypolipidemic potentials. We tested the hypothesis that prebiotics could alter motilin and gastrin secretion and reduce lipids in healthy preterms. Methods: A total of 167 newborns were randomized to either a prebiotics enriched formula containing dietary oligosaccharides (short‐chain galacto‐oligo‐saccharides/long‐chain fructo‐oligo‐saccharides [scGOS/lcFOS]), at a concentration of 0.8 g/100 ml, or a common preterm formula. Day 1 and 16 basal motilin, gastrin concentrations, and lipids were evaluated together with growth parameters, gastric residue, bowel habits, and feeding tolerance. Adverse events including necrotizing enterocolitis (NEC) and septicemia were also recorded. Results: Mean motilin increase and day 16 mean values were greater for the intervention, compared with the control group (P = .001, P = .005, respectively), while gastrin remained high in both groups. Mean cholesterol and low density lipoprotein (LDL) increase were significantly greater in the control, compared with the intervention (P = .037, and P = .001) group. Day 16 LDL levels were significantly higher in the control group. Mean weight was increased in the control group, while gastric residue was less and stool frequency was increased in the intervention group. NEC and septicemia were not statistically different between groups. Conclusion: A prebiotics enriched formula resulted in significant surge of motilin relating to reduced gastric residue, compared with a common preterm formula. Mean cholesterol change was lower, while LDL was not increased in the prebiotics group, compared with the control group.     

Profile of Folate in Breast Milk from Chinese Women over 1–400 Days Postpartum

Folate is an essential nutrient for growth in early life. This study aimed to determine the levels and compositions of folate in Chinese breast milk samples. This study was part of the Maternal Nutrition and Infant Investigation (MUAI) study. A total of 205 healthy mothers were randomly recruited in Chengdu over 1–400 days postpartum. Five different species of folate, including tetrahydrofolate (THF), 5-methyl-THF, 5,10-methenyl-THF,5-formyl-THF and unmetabolized folic acid (UMFA), were measured for liquid chromatography–tandem mass spectrometry (LC-MS). The median levels of total folate ranged from 12.86 to 56.77 ng/mL in the breast milk of mothers at 1–400 days postpartum, gradually increasing throughout the lactating periods. The median levels of 5-methyl-THF, minor reduced folate (the sum of THF, 5,10-methenyl-THF and 5-formyl-THF) and UMFA were in the ranges of 8.52–40.65 ng/mL, 3.48–16.15 ng/mL and 0.00–1.24 ng/mL during 1–400 days postpartum, respectively. 5-Methyl-THF accounted for more than 65% of the total folate in all breast milk samples. The levels of UMFA in mature breast milk samples were higher in supplement users than nonusers, but not for colostrum and transitional milk samples (p < 0.05). In conclusion, the level of total folate in the breast milk changed along with the prolonged lactating periods, but 5-methyl-THF remains the dominant species of folate in the breast milk of Chinese populations across all entire lactating periods.     

哺乳期农村乳母乳汁无机元素含量的变化

目的了解哺乳期人乳无机元素含量的变化及其与乳母膳食的关联。方法采用横断面调查方法,收集55名陕西省澄城县农村健康乳母清晨乳样,利用原子吸收分光光度法测定乳汁钙、镁、铁、锰、锌和铜的浓度。采用24小时回顾法进行连续3天膳食调查,计算膳食营养素的摄入量。结果农村乳母乳汁中镁、锌、铜浓度随哺乳期延长明显降低,铁浓度随哺乳期延长而上升。乳母膳食钙摄入量约为钙膳食参考摄入量(DRI)1/3,膳食无机元素的摄入量与人乳相应元素之间无明显相关性。多因素分析表明,乳汁中钙与镁、铁与铜、锰与锌均呈正相关,钙分别与乳脂、铁、锌呈负相关。结论随哺乳期时间延长,成熟乳中镁、锌、铜浓度降低而铁浓度增加,乳母膳食钙的摄入严重不足,乳汁各元素与膳食相应元素之间无关联。     

The Breast Milk Immunoglobulinome

Breast milk components contribute to the infant’s immune development and protection, and among other immune factors, immunoglobulins (Igs) are the most studied. The presence of IgA in milk has been known for a long time; however, less information is available about the presence of other Igs such as IgM, IgG, and their subtypes (IgG1, IgG2, IgG3, and IgG4) or even IgE or IgD. The total Ig concentration and profile will change during the course of lactation; however, there is a great variability among studies due to several variables that limit establishing a clear pattern. In this context, the aim of this review was firstly to shed light on the Ig concentration in breast milk based on scientific evidence and secondly to study the main factors contributing to such variability. A search strategy provided only 75 studies with the prespecified eligibility criteria. The concentrations and proportions found have been established based on the intrinsic factors of the study—such as the sampling time and quantification technique—as well as participant-dependent factors, such as lifestyle and environment. All these factors contribute to the variability of the immunoglobulinome described in the literature and should be carefully addressed for further well-designed studies and data interpretation.     

Bacterial Diversity of Breast Milk in Healthy Spanish Women: Evolution from Birth to Five Years Postpartum

The objective of this work was to characterize the microbiota of breast milk in healthy Spanish mothers and to investigate the effects of lactation time on its diversity. A total of ninety-nine human milk samples were collected from healthy Spanish women and were assessed by means of next-generation sequencing of 16S rRNA amplicons and by qPCR. Firmicutes was the most abundant phylum, followed by Bacteroidetes, Actinobacteria, and Proteobacteria. Accordingly, Streptococcus was the most abundant genus. Lactation time showed a strong influence in milk microbiota, positively correlating with Actinobacteria and Bacteroidetes, while Firmicutes was relatively constant over lactation. 16S rRNA amplicon sequencing showed that the highest alpha-diversity was found in samples of prolonged lactation, along with wider differences between individuals. As for milk nutrients, calcium, magnesium, and selenium levels were potentially associated with Streptococcus and Staphylococcus abundance. Additionally, Proteobacteria was positively correlated with docosahexaenoic acid (DHA) levels in breast milk, and Staphylococcus with conjugated linoleic acid. Conversely, Streptococcus and trans-palmitoleic acid showed a negative association. Other factors such as maternal body mass index or diet also showed an influence on the structure of these microbial communities. Overall, human milk in Spanish mothers appeared to be a complex niche shaped by host factors and by its own nutrients, increasing in diversity over time.     

母乳中免疫细胞的分泌功能与新生儿免疫

目的 探讨母乳中免疫细胞的分泌功能与新生儿免疫的关系。方法 采用双抗体夹心ELISA法检测母乳中单个核细胞分泌肿瘤坏死因子（TNF－α）、白细胞介质－6（IL－6）和白细胞介素－8（IL－8）的水平。结果 初乳组单个核细胞分泌细胞因子的水平（TNF－α中位数为0．364μg/L、IL－6中位数为0．114μg/L、IL－8中位数为0．644μg/L）均高于成熟乳组（P＜0．01）,而初乳组与母血组差别无显性意义;初乳TNF－α、IL－6、IL-8斩水平与母外周血相应指标不存在相关关系。结论 初乳中免疫细胞分泌细胞因子的水平明显高于成熟乳;母乳喂养可以提高新生儿抗感染免疫功能,大力提倡母乳喂养有利于新生儿健康。     

Six Oligosaccharides’ Variation in Breast Milk: A Study in South China from 0 to 400 Days Postpartum

This study investigated the variation in oligosaccharide levels in the breast milk of south Chinese mothers in a prolonged breastfeeding period of up to 400 days postpartum. A total of 488 breast milk samples were collected from 335 healthy mothers at five different time points: 0–5 days, 10–15 days, 40–45 days, 200–240 days, and 300–400 days postpartum. A high-performance anion-exchange chromatography-pulsed amperometric detector (HPAEC-PAD) was used to quantify 2′-fucosyllactose (2′-FL), 3-fucosyllactose (3-FL), lacto-N-tetraose (LNT), lacto-N-neotetraose (LNnT), 3′-sialyllactose (3′-SL) and 6′-sialyllactose (6′-SL). In this study, we found six oligosaccharides that were present in breast milk from 0 to 400 days postpartum. The median value ranges of individual oligosaccharide components in this study were 1013–2891 mg/L 2′-FL, 193–1421 mg/L 3-FL, 314–1478 mg/L LNT, 44–255 mg/L LNnT, 111–241 mg/L 3′-SL, and 23–602 mg/L6′-SL. HMO levels decreased over the lactation periods, except for 3-FL, which increased throughout lactation. The predominant fucosylated and sialylated HMOs were 2′-FL and 6′-SL at 40–45 days postpartum and changed to 3-FL and 3′-SL at 200–240 days postpartum. Results from this study showed that lactating women continue to provide their offspring with a high level of 2′-FL one year after delivery, suggesting that 2′-FL may play an important role for infants in early life. Our findings also provide further evidence in support of breastfeeding after one-year postpartum.     

广东江门地区3月龄婴儿血铅与乳母血铅及乳铅等因素的相关性研究

目的:了解广东省江门地区3月龄婴儿血铅与乳母血铅、乳铅等的相关关系,寻找影响婴儿血铅水平的高危因素。方法:采用横断面描述性人群调查方法,对2005年1~4月在广东省江门市新会区妇幼保健院出生的纯母乳或者混合喂养的新生儿在3月龄时分别进行婴儿血铅、乳母血铅与乳铅的测定,并结合其出生时脐带血铅水平,综合评价婴儿血铅的相关影响因素。结果:婴儿3月龄时血铅水平(49.53±23.6μg/L)与其对应的脐血铅水平(49.70±23.77μg/L)比较无显著性差异(P>0.05);但是两者均明显低于婴儿3月龄时乳母血铅水平(59.24±28.71μg/L)而高于此时的乳铅水平(26.77±13.70μg/L)(P均<0.05);而乳铅水平也明显低于同时采集的乳母血铅水平(P<0.05)。Spearman偏相关分析显示,婴儿3月龄血铅水平与出生时脐带血铅水平(Spearman偏相关系数rs=0.39,P<0.01)、乳母血铅水平(rs=0.42,P<0.01)以及乳铅水平(rs=0.31,P<0.01)均存在显著的正相关关系。多元回归分析显示,在校正了居住地点、铅接触史、性别等因素的影响后,母乳血铅每变化1μg/L,可相应引起婴儿血铅约14μg/L的变化。结论:乳母血铅及乳铅可明显影响3月龄婴儿血铅水平;乳铅的定量测定和分析,对儿童早期铅暴露的防治具有重要意义。     

陕西澄城县农村乳母膳食与乳汁营养素的调查分析

目的 了解陕西农村哺乳期乳母膳食和乳汁营养素的状况。方法 采取整群抽样的方法，对陕西澄城县农村乳母进行膳食调查、身体营养状况和乳汁营养素测定。运用CDGSS3.0营养软件计算膳食成分，利用SPSS11．0软件进行统计学处理。结果 陕西澄城县农村乳母膳食能量和蛋白质，尤其是优质蛋白质摄人严重不足；乳母身体消瘦发生率为23．64％；乳汁中蛋白质偏低而乳糖偏高；乳汁中能量与乳脂的变化一致；膳食和乳汁中相对应的营养素和能量相关系数差异无显著性。结论 在今后的农村工作中，应加快提高农村生活水平，加强乳母营养知识的教育，改善乳母的膳食营养状况。