Boehm G, Senger H, Braun W, Beyreiss K, Räihä N C
Department of Paediatrics, Karl-Marx-University Leipzig, GDR.
Acta Paediatr Scand. 1988 Jan;77(1):19-23. doi: 10.1111/j.1651-2227.1988.tb10591.x.
Metabolic response to human milk feeding was studied in 12 appropriate (AGA) and 12 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. Protein intake ranged from 1.98 to 2.47 g/kg/day and caloric intake from 94 to 126 kcal/kg/day with no significant differences between the groups. Alpha-amino-nitrogen, the total bile acid concentration in serum and total- as well as alpha-amino-nitrogen excretion in the urine were estimated. The alpha-amino-nitrogen and the total bile acid concentration in serum increased with increasing degree of intrauterine growth retardation. Also renal total- and alpha-amino-nitrogen excretion increased significantly in relation to the degree of intrauterine growth retardation. Thus, despite a relatively low protein intake in severely growth retarded VLBW-infants, metabolic changes could be found similar to those observed in AGA-infants on high protein intakes. The data suggest that during the first weeks of postnatal life VLBW-infants with intrauterine growth retardation have a decreased capacity to utilize or to metabolize protein when compared to AGA-infants with comparable birthweights. These metabolic differences have to be considered in the nutritional management of VLBW-infants.
对出生体重极低（VLBW）的12名适于胎龄（AGA）婴儿和12名小于胎龄（SGA）婴儿在出生后第8天对母乳喂养的代谢反应进行了研究。蛋白质摄入量为1.98至2.47克/千克/天，热量摄入量为94至126千卡/千克/天，两组之间无显著差异。对血清中的α-氨基氮、总胆汁酸浓度以及尿液中的总α-氨基氮排泄量进行了评估。血清中的α-氨基氮和总胆汁酸浓度随着宫内生长迟缓程度的增加而升高。肾脏的总α-氨基氮排泄量和α-氨基氮排泄量也随着宫内生长迟缓程度的增加而显著增加。因此，尽管严重生长迟缓的VLBW婴儿蛋白质摄入量相对较低，但仍可发现其代谢变化与高蛋白摄入的AGA婴儿相似。数据表明，与出生体重相当的AGA婴儿相比，出生后第一周内有宫内生长迟缓的VLBW婴儿利用或代谢蛋白质的能力下降。在VLBW婴儿的营养管理中必须考虑这些代谢差异。
