Cheu H W, Brown D R
Department of Surgery, Children's Hospital of Pittsburgh, PA.
Am J Dis Child. 1990 Feb;144(2):197-202. doi: 10.1001/archpedi.1990.02150260077032.
We measured breath hydrogen excretion in 103 neonates from birth to as late as 2 months of age. The patients weighed less than 2000 g at birth and were part of a study of hydrogen excretion as a screening test for necrotizing enterocolitis. Hydrogen excretion in parts per million was normalized for the quality of the expired air by dividing by the Pco2 of the gas sample The rise in the H2/CO2 ratio was influenced by gestational age, energy intake, and antibiotic usage but not by the daily frequency of feeding. The mean +/- SD peak H2/CO2 ratio was 5.1 +/- 3.6 ppm per millimeter of mercury and occurred at 16.0 +/- 11.0 days of age. The age at which the peak H2/CO2 occurred varied with gestational age. Patients born between 23 and 28 weeks gestational age (n = 34) were 22.9 +/- 13.1 days of age when they experienced their peak H2/CO2 ratio, whereas those born between 29 and 34 weeks gestational age (n = 62) were 12.2 +/- 7.5 days of age. The age at which the peak H2/CO2 ratio occurred did not differ between these two groups when corrected for the age at which oral intake exceeded 420 kJ/kg per day. These results suggest that premature neonates require experience with ingesting more than 420 kJ/kg per day before bacteria and carbohydrates are present in large enough quantities to permit measurable hydrogen production. This information will be useful in future studies of premature gut development and physiology and in studying pathologic processes in which malabsorption may play a role.
我们测量了103名新生儿从出生到2个月大时的呼气氢排泄量。这些患儿出生时体重不足2000克，是一项将氢排泄作为坏死性小肠结肠炎筛查试验研究的一部分。通过将百万分率的氢排泄量除以气体样本的二氧化碳分压，对呼出气体质量进行标准化。氢气/二氧化碳比值的升高受胎龄、能量摄入和抗生素使用的影响，但不受每日喂养频率的影响。氢气/二氧化碳比值的平均±标准差峰值为每毫米汞柱5.1±3.6 ppm，出现在16.0±11.0日龄。氢气/二氧化碳峰值出现的年龄随胎龄而变化。胎龄在23至28周之间出生的患儿（n = 34），在22.9±13.1日龄时出现氢气/二氧化碳比值峰值，而胎龄在29至34周之间出生的患儿（n = 62），在12.2±7.5日龄时出现该峰值。在校正口服摄入量超过每天420 kJ/kg的年龄后，这两组患儿氢气/二氧化碳比值峰值出现的年龄没有差异。这些结果表明，早产儿在细菌和碳水化合物数量足够多以允许产生可测量的氢气之前，需要有摄入超过每天420 kJ/kg的经验。这些信息将有助于未来对早产儿肠道发育和生理学的研究，以及对吸收不良可能起作用的病理过程的研究。
