Boehm G, Bierbach U, Senger H, Jakobsson I, Minoli I, Moro G, Räihä N C
Department of Pediatrics, University of Leipzig, Germany.
J Pediatr Gastroenterol Nutr. 1991 Apr;12(3):324-7. doi: 10.1097/00005176-199104000-00006.
In 18 low birth weight infants, small for gestational age, with different degrees of intrauterine growth retardation the activities of pancreatic lipase and trypsin and the concentrations of bile acids were measured in preprandially aspirated duodenal juice. The results were compared to those of 24 low birth weight infants, appropriate for gestational age, with comparable birth weights and postnatal ages. The activities of both measured pancreatic enzymes were negatively correlated with the degree of intrauterine growth retardation, expressed as the difference between the individual birth weight and the weight of the 10th percentile of the intrauterine growth curve (lipase: r = -0.697, p less than 0.001; trypsin: r = -0.739, p less than 0.001). The activity of trypsin in the small for gestational age infants was within the range of that found in the infants appropriate for gestational age. However, the lipase activity was decreased in infants who presented with growth retardation of greater than 400 g/kg birthweight. The concentrations of bile acids were similar in both groups (4.60 +/- 2.51 and 4.55 +/- 2.26 mmol/L, respectively) and sufficient for activating the bile salt stimulated lipase in human milk. The data suggest that in intrauterine growth retarded infants the lipase activity in the duodenal juice can be a limiting factor for optimal fat digestion. This should be considered in the nutritional management of such infants.
对18名低出生体重、小于胎龄且有不同程度宫内生长迟缓的婴儿，在餐前抽取十二指肠液，测定其中胰脂肪酶和胰蛋白酶的活性以及胆汁酸浓度。将结果与24名出生体重和出生后年龄相当的低出生体重、适于胎龄的婴儿进行比较。所测两种胰酶的活性均与宫内生长迟缓程度呈负相关，宫内生长迟缓程度用个体出生体重与宫内生长曲线第10百分位数体重之差表示（脂肪酶：r = -0.697，p < 0.001；胰蛋白酶：r = -0.739，p < 0.001）。小于胎龄婴儿的胰蛋白酶活性在适于胎龄婴儿的范围内。然而，出生体重低于400 g/kg且有生长迟缓的婴儿脂肪酶活性降低。两组胆汁酸浓度相似（分别为4.60±2.51和4.55±2.26 mmol/L），足以激活人乳中胆汁盐刺激的脂肪酶。数据表明，宫内生长迟缓婴儿十二指肠液中的脂肪酶活性可能是最佳脂肪消化的限制因素。在对此类婴儿进行营养管理时应考虑这一点。
