De Curtis M, Vetrano G
Pediatr Med Chir. 1986 Jul-Aug;8(4):437-42.
Protein, fat and carbohydrate absorption in preterm infants fed on human milk or formulae are reviewed. Even in the most premature infants absorption of protein is satisfactory. Nitrogen net absorption is about 85-90% of intake and results slightly lower with human milk than with formulae. The lower apparent digestibility of human milk is probably due to the poorly degraded IgA immunoglobulins and the rapid transit time. Lactose is well tolerated by the preterm infants despite the low lactase activity at birth. Glucose polymers, which have a low osmotic activity and are suitable for increasing carbohydrate intake of formulae, are well absorbed probably for the activity of salivary amylase and brush border glucoamylase, which have been shown to be well developed at birth. Premature infants absorb fat poorly. This malabsorption that increases with the lowering of gestational age is due to low pancreatic lipase activity and to low intraluminal concentration of bile salts. Due to its bile stimulated lipase activity, non-heat-treated human milk used at least in part is an effective method to improve fat absorption in preterm infants. Faecal energy determined using a calorimetric bomb appears to be a simple and an accurate method to predict faecal fat and avoiding expensive and cumbersome analysis.
本文综述了以母乳或配方奶喂养的早产儿蛋白质、脂肪和碳水化合物的吸收情况。即使是极早产儿，蛋白质的吸收也令人满意。氮的净吸收量约为摄入量的85%-90%，母乳喂养时的氮净吸收量略低于配方奶喂养。母乳较低的表观消化率可能是由于免疫球蛋白A降解不佳和转运时间较快。尽管早产儿出生时乳糖酶活性较低，但他们对乳糖耐受性良好。葡萄糖聚合物具有低渗透活性，适合增加配方奶中的碳水化合物摄入量，由于唾液淀粉酶和刷状缘葡糖淀粉酶的活性，葡萄糖聚合物可能被很好地吸收，这些酶在出生时已发育良好。早产儿脂肪吸收较差。随着胎龄降低，这种吸收不良会加剧，这是由于胰腺脂肪酶活性低和肠腔内胆汁盐浓度低所致。至少部分使用未经热处理的母乳，因其胆汁刺激脂肪酶活性，是改善早产儿脂肪吸收的有效方法。使用量热弹测定粪便能量似乎是预测粪便脂肪的简单且准确的方法，可避免昂贵且繁琐的分析。
