Iyngkaran N, Yadav M, Looi L M, Boey C G, Lam K L, Balabaskaran S, Puthucheary S D
Department of Paediatrics, University of Malaya, Kuala Lumpur.
J Pediatr Gastroenterol Nutr. 1988 Jan-Feb;7(1):68-75. doi: 10.1097/00005176-198801000-00014.
The effect of soy protein on the small bowel mucosa of 18 infants with acute gastroenteritis was studied. The infants were maintained on a protein hydrolysate formula for 6-8 weeks, following which they were readmitted for soy protein challenge studies. Jejunal biopsy was performed before and 24 h after challenge. On the basis of the clinical and histological reaction to soy protein challenge, three groups were identified. Group 1 consisted of three infants who had clinical and histological reaction. There was associated depletion of mucosal enzymes, lactase, sucrase, malatase, alkaline phosphatase, and blood xylose levels. Group 2 consisted of seven infants who had histological reaction but no clinical symptoms. Two of these seven infants, however, developed clinical reaction when rechallenged with soy protein 2 and 90 days later. Following challenge, mucosal enzymes and blood xylose levels were depressed in five of the seven infants tested. Group 3 consisted of eight infants who did not have either a clinical or a histological reaction. The mucosal enzymes and blood xylose levels were not depressed in four infants tested. The present study shows that the small bowel mucosa of some young infants recovering from acute gastroenteritis remains sensitive to soy protein for a variable period of time. The feeding of soy protein to these infants may result in the persistence of mucosal damage and perpetuation of diarrhea.(ABSTRACT TRUNCATED AT 250 WORDS)
研究了大豆蛋白对18例急性胃肠炎婴儿小肠黏膜的影响。这些婴儿先接受6 - 8周的蛋白水解物配方奶粉喂养,之后再次入院进行大豆蛋白激发试验研究。在激发试验前及激发后24小时进行空肠活检。根据对大豆蛋白激发试验的临床和组织学反应,分为三组。第1组由3例有临床和组织学反应的婴儿组成。伴有黏膜酶、乳糖酶、蔗糖酶、苹果酸酶、碱性磷酸酶的消耗以及血木糖水平下降。第2组由7例有组织学反应但无临床症状的婴儿组成。然而,这7例婴儿中有2例在2天和90天后再次接受大豆蛋白激发试验时出现了临床反应。在激发试验后,所检测的7例婴儿中有5例黏膜酶和血木糖水平降低。第3组由8例既无临床反应也无组织学反应的婴儿组成。所检测的4例婴儿黏膜酶和血木糖水平未降低。本研究表明,一些从急性胃肠炎恢复的幼儿小肠黏膜在一段可变的时间内对大豆蛋白仍保持敏感。给这些婴儿喂食大豆蛋白可能导致黏膜损伤持续存在和腹泻迁延不愈。(摘要截短于250字)