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母乳与迁延性腹泻患儿小肠黏膜恢复率

Human milk and the rate of small intestinal mucosal recovery in protracted diarrhea.

作者信息

Shulman R J, Lifschitz C H, Langston C, Gopalakrishna G S, Nichols B L

机构信息

USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Houston, TX 77030.

出版信息

J Pediatr. 1989 Feb;114(2):218-24. doi: 10.1016/s0022-3476(89)80786-3.

Abstract

STUDY OBJECTIVE

To determine whether human milk accelerates the recovery rate of injured small intestinal mucosa.

DESIGN

Randomized, controlled trial.

SETTING

County and nonprofit, private urban hospitals.

PATIENTS

Moderately to severely malnourished infants less than 6 months of age who required parenteral nutrition for treatment of protracted diarrhea.

INTERVENTIONS

Either a human milk preparation (n = 7) or sterile water (n = 9) was administered by continuous nasogastric feeding (14 mL/kg/d) over a 2-week study period while the infants received parenteral nutrition.

MEASUREMENTS AND MAIN RESULTS

Small intestine perfusion studies and biopsies were performed at the beginning and end of the study. Age, duration of prior illness, severity of malnutrition, glucose and water absorption, disaccharidase activities, atrophy of villi, and nutritional intake were comparable in both groups of infants. At the end of the 2-week study, improvement toward normal sucrase activity and intraepithelial lymphocytes was found in significantly fewer infants in the milk group than in the water group. No differences were noted in glucose and water absorption or in lactase and maltase activities as a function of the milk versus water treatment.

CONCLUSIONS

Human milk did not accelerate functional recovery of the small intestinal mucosa.

摘要

研究目的

确定母乳是否能加快受损小肠黏膜的恢复速度。

设计

随机对照试验。

地点

县级及非营利性私立城市医院。

患者

6个月以下中度至重度营养不良的婴儿,因迁延性腹泻需要肠外营养治疗。

干预措施

在为期2周的研究期间,当婴儿接受肠外营养时,通过持续鼻胃管喂养(14毫升/千克/天)给予母乳制剂(n = 7)或无菌水(n = 9)。

测量指标及主要结果

在研究开始和结束时进行小肠灌注研究和活检。两组婴儿在年龄、既往疾病持续时间、营养不良严重程度、葡萄糖和水吸收、双糖酶活性、绒毛萎缩以及营养摄入方面具有可比性。在为期2周的研究结束时,与水组相比,母乳组中蔗糖酶活性和上皮内淋巴细胞恢复正常的婴儿明显较少。在葡萄糖和水吸收以及乳糖酶和麦芽糖酶活性方面,未发现母乳与水治疗之间存在差异。

结论

母乳并未加快小肠黏膜的功能恢复。

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