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生牛乳相对于婴儿配方奶能改善早产儿肠道对喂养的反应。

Raw bovine milk improves gut responses to feeding relative to infant formula in preterm piglets.

机构信息

30 Rolighedsvej, DK-1958 Frederiksberg C, Denmark.

出版信息

Am J Physiol Gastrointest Liver Physiol. 2014 Jan 1;306(1):G81-90. doi: 10.1152/ajpgi.00255.2013. Epub 2013 Oct 24.

Abstract

For preterm neonates, the quality of the first milk is crucial for intestinal maturation and resistance to necrotizing enterocolitis (NEC). Among other factors, milk quality is determined by the stage of lactation and processing. We hypothesized that unprocessed mature bovine milk (BM; raw bovine milk) would have less bioactivity than corresponding bovine colostrum (BC) in a preterm pig model, but have improved bioactivity relative to its homogenized, pasteurized, spray-dried equivalent, whole milk powder (WMP), or a bovine milk protein-based infant formula (IF). For 5 days, newborn preterm pigs received parenteral and enteral nutrition consisting of IF (n = 13), BM (n = 13), or BC (n = 14). In a second study, WMP (n = 15) was compared with IF (n = 10) and BM (n = 9). Compared with pigs fed IF, pigs that were fed BM had significantly improved intestinal structure (mucosal weight, villus height) and function (increased nutrient absorption and enzyme activities, decreased gut permeability, nutrient fermentation, and NEC severity). BC further improved these effects relative to BM (lactase activity, lactose absorption, plasma citrulline, and tissue interleukin-8). WMP induced similar effects as BM, except for lactase activity and lactose absorption. In conclusion, the maturational and protective effects on the immature intestine decreased in the order BC>BM>WMP, but all three intact bovine milk diets were markedly better than IF. The stage of lactation (colostrum vs. mature milk) and milk processing (e.g., homogenization, fractionation, pasteurization, spray-drying) are important factors in determining milk quality during the early postnatal period of preterm neonates.

摘要

对于早产儿来说,初乳的质量对肠道成熟和抵抗坏死性小肠结肠炎(NEC)至关重要。在其他因素中,牛奶质量取决于泌乳期和加工方式。我们假设,在早产儿猪模型中,未经处理的成熟牛奶(BM;生牛奶)的生物活性将低于相应的牛初乳(BC),但与均质化、巴氏杀菌、喷雾干燥的等价物、全脂奶粉(WMP)或基于牛乳蛋白的婴儿配方奶粉(IF)相比,其生物活性会提高。在 5 天的时间里,新生早产儿接受肠外和肠内营养,包括 IF(n = 13)、BM(n = 13)或 BC(n = 14)。在第二项研究中,将 WMP(n = 15)与 IF(n = 10)和 BM(n = 9)进行了比较。与 IF 喂养的猪相比,BM 喂养的猪的肠道结构(黏膜重量、绒毛高度)和功能(增加营养吸收和酶活性、降低肠道通透性、营养发酵和 NEC 严重程度)明显改善。与 BM 相比,BC 进一步改善了这些效果(乳糖酶活性、乳糖吸收、血浆瓜氨酸和组织白细胞介素-8)。WMP 诱导的效果与 BM 相似,但乳糖酶活性和乳糖吸收除外。总之,对未成熟肠道的成熟和保护作用的顺序为 BC>BM>WMP,但所有三种完整的牛乳饮食都明显优于 IF。泌乳期(初乳与成熟乳)和牛奶加工(如均质化、分级、巴氏杀菌、喷雾干燥)是决定早产儿出生后早期牛奶质量的重要因素。

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