迟发型母乳性黄疸与婴儿排便频次的相关性

  目的  研究迟发型母乳性黄疸（LBMJ）的相关性因素,为LBMJ病因研究提供参考依据。  方法  选取昆明医科大学第一临床学院0～6月龄纯母乳喂养足月儿102例,根据不同排便频次分为排便频次增多组,即排便 > 3次/d（A组,n = 37）;排便频次减少组,即超过4 d排便1次（B组,n = 34）;排便频次正常组,即3d以内排便1次或排便≤3次/d（C组,n = 31）;选取的黄疸患儿均为LBMJ,分析LBMJ婴儿和其排便频次及日龄、喂养频次之间的相关性。  结果  （1）纯母乳喂养婴儿的日龄与其不同排便频次差异有统计学意义（Hc = 7.8007,P = 0.0202）;排便频次改变与有无LBMJ差异无统计学意义（χ2 = 5.8649,P = 0.0533）,但经趋势性卡方检验发现LBMJ的发生率随着排便次数的增多而增高（χ2 = 5.7593,P = 0.0164）;（2）LBMJ与婴儿排便频次和喂养频率呈正相关,并且以上因素均与婴儿日龄呈负相关。  结论  0～6月龄婴儿日龄越小,母乳喂养的频次越多,排便频次也越多,LBMJ发生率越高;另外,LBMJ的胆红素肠肝循环途径增强与婴儿的排便频次增多相关性较小。

Study on the Correlation between Late-onset Breast Milk Jaundice and Defecation Frequency in Infants

  Objective  To analyze the correlation factors of late-onset breast-feeding jaundice （LBMJ）, and provide the reference for the study of LBMJ etiology.   Methods  102 full-term breast-fed infants aged 0-6 months from the First Affiliated Hospital of Kunming Medical University were selected as the participants of this study and according to their defecation frequency they were divided respectively into defecation frequency increased group or group A, i.e. defecation > 3 times / D （ n = 37）, decreased defecation frequency group or group B, i.e. one defecation in more than 4 days （n = 34） and the normal group or group C, i.e. defecating once within 3 days or 3 times a day （n = 31）. All the infants with jaundice were LBMJ and the correlation between LBMJ and defecation frequency, age and feeding frequency was analyzed.   Results  1. There was a statistical difference between the age of exclusively breast-fed infants and their different defecation frequency （Hc =7.8007, P = 0.0202）. There was no significant difference between the change of defecation frequency and the absence of LBMJ （χ2 = 5.8649, P = 0.0533）, but the incidence of LBMJ increased with the increase of defecation frequency （χ2 =5.7593, P = 0.0164）. 2. LBMJ was positively correlated with the defecation frequency and feeding frequency in infants, and the above factors were negatively correlated with the age of infants.   Conclusion  The younger the infants aged from 0 to 6 months, the more frequent the breastfeeding, the more frequent the defecation and the higher the incidence of LBMJ. In addition, the enhancement of bilirubin enterohepatic circulation pathway in LBMJ has little correlation with the increased defecation frequency in infants.