Törnhage C J, Serenius F, Uvnäs-Moberg K, Lindberg T
Department of Paediatrics, Umeå University, Sweden.
J Pediatr Gastroenterol Nutr. 1998 Aug;27(2):199-205. doi: 10.1097/00005176-199808000-00014.
The functions of the gut are modulated by the autonomic nervous system and gut peptides, such as somatostatin and cholecystokinin, which have opposite functions. This study reports plasma somatostatin and cholecystokinin levels in response to feeding in preterm infants.
In 76 infants--gestational age 23 to 36 weeks, birth weight 460 to 2867 g--blood samples were taken on day 1 before the first meal in life, and 30 minutes after the end of the meal. Samples were again taken on days 3 and 4. The infants were fed human milk by nasogastric tube, by breast, or by bottle. In 10 additional infants, (gestational age 27-36 weeks) who were studied at a median postnatal age of 15 days, the response of the peptides to breast-feeding was compared with that of tube-feeding. Plasma somatostatin and cholecystokinin were analyzed by specific radioimmunoassays.
On day 1, the median plasma somatostatin level increased after feeding in small-for-gestational-age infants but not in appropriate-for-gestational-age infants. On days 3 and 4, the somatostatin level decreased in infants with a gestational age of 32 weeks or more. On day 1, plasma cholecystokinin levels increased in infants with a gestational age of 32 weeks or more: The response was more pronounced in small-for-gestational-age infants. On days 3 and 4, plasma cholecystokinin levels increased only in breast-feeding infants. In the 10 infants fed by breast and by tube, plasma cholecystokinin levels increased after breast-feeding and tended to increase after tube-feeding. The plasma somatostatin levels were unaffected after feeding.
Plasma somatostatin and cholecystokinin increased after feeding in small-for-gestational-age infants on day 1. On days 3 and 4, the responses to feeding seemed to be dependent on the infant's gestational age. Breast-feeding enhanced the release of cholecystokinin but not that of somatostatin.
肠道功能受自主神经系统和肠道肽（如具有相反功能的生长抑素和胆囊收缩素）调节。本研究报告了早产儿进食后血浆生长抑素和胆囊收缩素水平。
选取76例婴儿（胎龄23至36周，出生体重460至2867克），在出生后第1天首次进食前及进食结束后30分钟采集血样。在第3天和第4天再次采集血样。婴儿通过鼻胃管、母乳喂养或奶瓶喂养人乳。另外选取10例婴儿（胎龄27 - 36周），在出生后15天的中位年龄进行研究，比较肽类对母乳喂养和管饲喂养的反应。采用特异性放射免疫分析法分析血浆生长抑素和胆囊收缩素。
在第1天，小于胎龄儿进食后血浆生长抑素水平中位数升高，而适于胎龄儿未升高。在第3天和第4天，胎龄32周及以上的婴儿生长抑素水平下降。在第1天，胎龄32周及以上的婴儿血浆胆囊收缩素水平升高：小于胎龄儿的反应更明显。在第3天和第4天，仅母乳喂养的婴儿血浆胆囊收缩素水平升高。在10例通过母乳喂养和管饲喂养的婴儿中，母乳喂养后血浆胆囊收缩素水平升高，管饲喂养后有升高趋势。进食后血浆生长抑素水平未受影响。
小于胎龄儿在第1天进食后血浆生长抑素和胆囊收缩素升高。在第3天和第4天，对进食的反应似乎取决于婴儿的胎龄。母乳喂养增强了胆囊收缩素的释放，但未增强生长抑素的释放。
