Berseth C L, Nordyke C
Department of Pediatrics, Mayo Clinic, Rochester, Minnesota 55905.
Am J Physiol. 1993 Jun;264(6 Pt 1):G1046-51. doi: 10.1152/ajpgi.1993.264.6.G1046.
Low-compliance perfusion manometry and clinical outcome were used to assess the chronic effects of feeding on functional maturation of the preterm intestine in 32 infants. During the first postnatal week, 16 infants received a small volume of formula to supplement their routine parenteral nutrition (24 ml.kg-1.day-1), and 16 received an equal volume of water. After 10 days of enteral "feedings," the manometric tracings of those infants who had received nutrient feedings had more migrating activity (P < 0.01) and less clustered phasic activity (P < 0.05) during fasting than did the tracings of those infants who had received nonnutrient feedings containing sterile water. Infants who received nutrient feedings demonstrated a change in motor activity in response to feeding; infants who had received water feedings failed to show a change in motor activity in response to feeding. After water-fed infants were given formula feedings for 2 wk, their motor activity patterns were similar to those who had initially been fed formula, and their motor responses to feeding were restored. Despite normalization of their motor activity patterns by 1 mo of age, these water-fed infants established full enteral nutrition and full nipple feedings later than did infants who had been fed formula (P < 0.01), suggesting that the delay of enteral feedings in preterm infants does not permit optimal intestinal maturation of nonmucosal functions.
采用低顺应性灌注测压法和临床结局评估32例婴儿喂养对早产肠功能成熟的慢性影响。在出生后的第一周，16例婴儿接受少量配方奶以补充常规肠外营养（24毫升·千克⁻¹·天⁻¹），16例婴儿接受等量的水。在进行10天肠内“喂养”后，与接受含无菌水的非营养性喂养的婴儿相比，接受营养性喂养的婴儿在禁食期间的测压描记显示出更多的移行活动（P<0.01）和更少的成簇相性活动（P<0.05）。接受营养性喂养的婴儿在进食时表现出运动活动的变化；接受水喂养的婴儿在进食时未表现出运动活动的变化。水喂养的婴儿在接受2周配方奶喂养后，其运动活动模式与最初接受配方奶喂养的婴儿相似，并且其对进食的运动反应得以恢复。尽管这些水喂养的婴儿在1月龄时运动活动模式恢复正常，但他们建立完全肠内营养和完全奶瓶喂养的时间比接受配方奶喂养的婴儿晚（P<0.01），这表明早产婴儿延迟肠内喂养不能使非黏膜功能实现最佳的肠道成熟。
