Riva E, Agostoni C, Biasucci G, Trojan S, Luotti D, Fiori L, Giovannini M
Department of Paediatrics, University of Milan Medical School, Italy.
Acta Paediatr. 1996 Jan;85(1):56-8. doi: 10.1111/j.1651-2227.1996.tb13890.x.
Strict control of phenylalanine intake is the main dietary intervention for phenylketonuric children. Whether other dietary-related factors improve the clinical outcome for treated phenylketonuric children in neurodevelopmental terms, however, remains unexplored. We retrospectively compared the intelligence quotient (IQ) score of 26 school-age phenylketonuric children who were either breastfed or formula fed for 20-40 days prior to dietary intervention. Children who had been breastfed as infants scored significantly better (IQ advantage of 14.0 points, p = 0.01) than children who had been formula fed. A 12.9 point advantage persisted also after adjusting for social and maternal education status (p = 0.02). In this sample of early treated term infants with phenylketonuria there was no associated between IQ scores and the age at treatment onset and plasma phenylalanine levels during treatment. We conclude that breastfeeding in the prediagnostic stage may help treated infants and children with phenylketonuria to improve neurodevelopmental performance.
严格控制苯丙氨酸摄入量是苯丙酮尿症患儿主要的饮食干预措施。然而，其他与饮食相关的因素是否能从神经发育角度改善接受治疗的苯丙酮尿症患儿的临床结局，仍有待探索。我们回顾性比较了26名学龄期苯丙酮尿症患儿的智商（IQ）得分，这些患儿在饮食干预前曾进行20 - 40天的母乳喂养或配方奶喂养。婴儿期接受母乳喂养的儿童得分显著高于接受配方奶喂养的儿童（IQ优势为14.0分，p = 0.01）。在调整社会和母亲教育状况后，仍存在12.9分的优势（p = 0.02）。在这个早期接受治疗的足月苯丙酮尿症婴儿样本中，IQ得分与治疗开始年龄以及治疗期间血浆苯丙氨酸水平之间没有关联。我们得出结论，诊断前阶段的母乳喂养可能有助于接受治疗的苯丙酮尿症婴幼儿改善神经发育表现。
