Thorkelsson T, Mimouni F, Namgung R, Fernández-Ulloa M, Krug-Wispé S, Tsang R C
Department of Pediatrics, Children's Hospital Research Foundation, Cincinnati, Ohio 45267-0541.
Pediatr Res. 1994 Sep;36(3):329-33. doi: 10.1203/00006450-199409000-00010.
Casein-predominant infant milk formulas have been speculated to predispose to lactobezoar formation in preterm infants due to delayed gastric emptying. There have been, however, no prospective studies to prove this possibility. In a randomized, double-blinded, prospective study, we tested the hypothesis that preterm infants fed casein-predominant milk formula have slower gastric emptying than infants fed whey-predominant formulas. Twenty preterm infants within the first 4 d of life were randomized to receive either the whey-predominant formula Similac Special Care (whey:casein ratio 60:40) or an experimental casein-predominant formula (whey:casein ratio 18:82). Only the protein composition differed between the two formulas. The infants were fed the assigned study formula until they reached approximately 2200 g body weight when a gastric emptying scan was performed, using the designated study formula mixed with 25 microCi of technetium-99 sulfur colloid. Gastric emptying was followed continuously for 2 h. Gastric emptying at 30, 60, 90, and 120 min was similar between the two study groups. The time for 50% gastric emptying was 64.9 +/- 12.3 min for the infants fed the whey-predominant formula and 56.5 +/- 14.8 min for those fed the casein-predominant formula (p = 0.75). We conclude that the rate of gastric emptying in preterm infants fed casein-predominant formulas is similar to that in those fed whey-predominant formulas.
酪蛋白为主的婴儿配方奶粉一直被推测由于胃排空延迟，易导致早产儿形成乳糖凝块。然而，尚无前瞻性研究来证实这种可能性。在一项随机、双盲、前瞻性研究中，我们检验了以下假设：喂食酪蛋白为主的奶粉的早产儿比喂食乳清蛋白为主的奶粉的婴儿胃排空更慢。20名出生后4天内的早产儿被随机分为两组，分别接受乳清蛋白为主的配方奶粉Similac Special Care（乳清蛋白：酪蛋白比例为60:40）或一种实验性的酪蛋白为主的配方奶粉（乳清蛋白：酪蛋白比例为18:82）。两种配方奶粉仅蛋白质组成不同。这些婴儿喂食指定的研究配方奶粉，直到体重达到约2200克时进行胃排空扫描，扫描时使用与25微居里的锝-99硫胶体混合的指定研究配方奶粉。连续监测胃排空2小时。两个研究组在30、60、90和120分钟时的胃排空情况相似。喂食乳清蛋白为主的配方奶粉的婴儿胃排空50%的时间为64.9±12.3分钟，喂食酪蛋白为主的配方奶粉的婴儿为56.5±14.8分钟（p = 0.75）。我们得出结论，喂食酪蛋白为主的配方奶粉的早产儿的胃排空速率与喂食乳清蛋白为主的配方奶粉的早产儿相似。
