Gourley G R, Arend R A
Lancet. 1986 Mar 22;1(8482):644-6. doi: 10.1016/s0140-6736(86)91724-1.
Breast milk or formula milk and serum samples from 34 breast-fed babies, 15 formula-fed babies, and their mothers were examined at 3 and 21 days of neonatal age. Infant faecal samples were obtained on day 21 only. At both ages serum total bilirubin concentrations were significantly higher in breast-fed than in formula-fed infants. Beta-glucuronidase activity in formula milk was negligible while that in human milk was considerable. Day 21 faecal beta-glucuronidase was higher in the breast-fed babies. In the breast-fed babies, serum bilirubin levels were related to concentrations of beta-glucuronidase in breast milk on both days 3 and 21 and to levels of faecal beta-glucuronidase on day 21. In 4 additional babies whose feeds were temporarily changed from breast milk to formula milk because of hyperbilirubinaemia there was a striking decrease in faecal beta-glucuronidase activity coincident with a fall in serum bilirubin. Breast milk beta-glucuronidase seems to be an important factor in the neonatal hyperbilirubinaemia of breast-fed babies.
对34名母乳喂养婴儿、15名配方奶喂养婴儿及其母亲在新生儿3日龄和21日龄时的母乳或配方奶以及血清样本进行了检测。仅在21日龄时采集婴儿粪便样本。在这两个年龄段，母乳喂养婴儿的血清总胆红素浓度均显著高于配方奶喂养婴儿。配方奶中的β-葡萄糖醛酸酶活性可忽略不计，而人乳中的该活性相当可观。母乳喂养婴儿在21日龄时粪便中的β-葡萄糖醛酸酶含量更高。在母乳喂养婴儿中，血清胆红素水平在3日龄和21日龄时均与母乳中β-葡萄糖醛酸酶的浓度以及21日龄时粪便中β-葡萄糖醛酸酶的水平相关。另外4名因高胆红素血症而暂时从母乳喂养改为配方奶喂养的婴儿，其粪便中β-葡萄糖醛酸酶活性显著下降，同时血清胆红素水平也随之降低。母乳中的β-葡萄糖醛酸酶似乎是母乳喂养婴儿发生新生儿高胆红素血症的一个重要因素。
