中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2014年
7期
510-515
,共6页
韩露艳%黎明%余欣庭%孙秀静%王丹华
韓露豔%黎明%餘訢庭%孫秀靜%王丹華
한로염%려명%여흔정%손수정%왕단화
母乳%激素%早产%婴儿%生长
母乳%激素%早產%嬰兒%生長
모유%격소%조산%영인%생장
Human milk%Hormones%Premature%Infant%Growth
目的 探讨早产初乳和成熟乳中脂联素、瘦素、真胰岛素和胃生长素水平及其对早产儿生长发育的影响.方法 设早产组和正常组.收集初乳、42 d成熟乳,记录产妇一般情况及婴儿出生时及生后42 d生长情况.检测母乳中激素水平,比较两组母乳中激素水平、婴儿生长情况并分析各激素与婴儿生长的关系.结果 共入组128对母婴.收集初乳128份(早产组80份,正常组48份);成熟乳94份(早产组50份,正常组44份).两组初乳、成熟乳中脂联素、瘦素、真胰岛素水平比较差异均无统计学意义(P＞0.05).胃生长素水平早产组均低于正常组,初乳为130.5 vs.175.4ng/L (P =0.042),成熟乳为188.2vs.319.7 ng/L(P=0.038).初乳中脂联素、瘦素水平均高于成熟乳,早产组为10.5vs.2.1μg/L、11.0vs.3.3 μg/L;正常组为0.44vs.0.20 μg/L、0.50vs.0.22 μg/L(P均＜0.05).早产组、正常组初乳中胃生长素水平均低于成熟乳(130.5vs.188.2 ng/L,175.4vs.319.7 ng/L,P均＜0.05).不同胎龄组(≤34周组与＞34周组比较)初乳、成熟乳中脂联素、瘦素、胃生长素比较差异无统计学意义,≤34周组成熟乳真胰岛素水平高于＞ 34周组(29.3vs.21.6 mU/L,P=0.045).≤34周组初乳中真胰岛素水平低于成熟乳(21.7 vs.29.3 mU/L,P=0.000).初乳中脂联素水平与42 d体重增长值呈负相关(r=-0.362,P=0.025).成熟乳中胰岛素水平与出生体重呈负相关(r=-0.319,P=0.029).初乳中胃生长素水平与出生体重、身长、头围呈正相关(r分别为0.271,0.261,0.360,P均＜0.05);与42 d头围呈正相关(r=0.360,0.028);与42 d体重、身长呈临界正相关(P值分别为0.050、0.058).结论 母乳中含有许多具有生物活性的激素,共同参与调节早产儿出生后的适宜生长.早产可影响母乳中某些激素水平的变化.在早产儿中提倡母乳喂养非常重要.
目的 探討早產初乳和成熟乳中脂聯素、瘦素、真胰島素和胃生長素水平及其對早產兒生長髮育的影響.方法 設早產組和正常組.收集初乳、42 d成熟乳,記錄產婦一般情況及嬰兒齣生時及生後42 d生長情況.檢測母乳中激素水平,比較兩組母乳中激素水平、嬰兒生長情況併分析各激素與嬰兒生長的關繫.結果 共入組128對母嬰.收集初乳128份(早產組80份,正常組48份);成熟乳94份(早產組50份,正常組44份).兩組初乳、成熟乳中脂聯素、瘦素、真胰島素水平比較差異均無統計學意義(P＞0.05).胃生長素水平早產組均低于正常組,初乳為130.5 vs.175.4ng/L (P =0.042),成熟乳為188.2vs.319.7 ng/L(P=0.038).初乳中脂聯素、瘦素水平均高于成熟乳,早產組為10.5vs.2.1μg/L、11.0vs.3.3 μg/L;正常組為0.44vs.0.20 μg/L、0.50vs.0.22 μg/L(P均＜0.05).早產組、正常組初乳中胃生長素水平均低于成熟乳(130.5vs.188.2 ng/L,175.4vs.319.7 ng/L,P均＜0.05).不同胎齡組(≤34週組與＞34週組比較)初乳、成熟乳中脂聯素、瘦素、胃生長素比較差異無統計學意義,≤34週組成熟乳真胰島素水平高于＞ 34週組(29.3vs.21.6 mU/L,P=0.045).≤34週組初乳中真胰島素水平低于成熟乳(21.7 vs.29.3 mU/L,P=0.000).初乳中脂聯素水平與42 d體重增長值呈負相關(r=-0.362,P=0.025).成熟乳中胰島素水平與齣生體重呈負相關(r=-0.319,P=0.029).初乳中胃生長素水平與齣生體重、身長、頭圍呈正相關(r分彆為0.271,0.261,0.360,P均＜0.05);與42 d頭圍呈正相關(r=0.360,0.028);與42 d體重、身長呈臨界正相關(P值分彆為0.050、0.058).結論 母乳中含有許多具有生物活性的激素,共同參與調節早產兒齣生後的適宜生長.早產可影響母乳中某些激素水平的變化.在早產兒中提倡母乳餵養非常重要.
목적 탐토조산초유화성숙유중지련소、수소、진이도소화위생장소수평급기대조산인생장발육적영향.방법 설조산조화정상조.수집초유、42 d성숙유,기록산부일반정황급영인출생시급생후42 d생장정황.검측모유중격소수평,비교량조모유중격소수평、영인생장정황병분석각격소여영인생장적관계.결과 공입조128대모영.수집초유128빈(조산조80빈,정상조48빈);성숙유94빈(조산조50빈,정상조44빈).량조초유、성숙유중지련소、수소、진이도소수평비교차이균무통계학의의(P＞0.05).위생장소수평조산조균저우정상조,초유위130.5 vs.175.4ng/L (P =0.042),성숙유위188.2vs.319.7 ng/L(P=0.038).초유중지련소、수소수평균고우성숙유,조산조위10.5vs.2.1μg/L、11.0vs.3.3 μg/L;정상조위0.44vs.0.20 μg/L、0.50vs.0.22 μg/L(P균＜0.05).조산조、정상조초유중위생장소수평균저우성숙유(130.5vs.188.2 ng/L,175.4vs.319.7 ng/L,P균＜0.05).불동태령조(≤34주조여＞34주조비교)초유、성숙유중지련소、수소、위생장소비교차이무통계학의의,≤34주조성숙유진이도소수평고우＞ 34주조(29.3vs.21.6 mU/L,P=0.045).≤34주조초유중진이도소수평저우성숙유(21.7 vs.29.3 mU/L,P=0.000).초유중지련소수평여42 d체중증장치정부상관(r=-0.362,P=0.025).성숙유중이도소수평여출생체중정부상관(r=-0.319,P=0.029).초유중위생장소수평여출생체중、신장、두위정정상관(r분별위0.271,0.261,0.360,P균＜0.05);여42 d두위정정상관(r=0.360,0.028);여42 d체중、신장정림계정상관(P치분별위0.050、0.058).결론 모유중함유허다구유생물활성적격소,공동삼여조절조산인출생후적괄의생장.조산가영향모유중모사격소수평적변화.재조산인중제창모유위양비상중요.
Objective To understand adiponectin,leptin,insulin and ghrelin levels in preterm colostrum and mature milk and their influence on the growth and development of the premature infant.Method The study subjects were divided into two groups:preterm group and control group.Specimens of colostrum and mature milk on 42nd day after delivery were collected,the general situation of maternal and infants growth parameters at birth and at postnatal 42 days were recorded.Leptin,adiponectin,insulin and ghrelin levels in colustrum and mature milk were determined and compared.Result A total of 128 mother-infant pairs were involved.There were 128 specimens of colostrums (80 from preterm group,48 from control group) and 94 specimens of mature milk(50 from premature group,44 from control group).The levels of colostrum,mature milk adiponectin,leptin,and insulin were not significantly different between the 2 groups; ghrelin levels in colostrum and mature milk of premature group were significantly lower than those in control group (P =0.038),adiponectin and leptin levels in colostrum were higher than those of the mature milk (P ＜ 0.05),colostrum ghrelin levels were lower than those of mature milk (P ＜ 0.05).Adiponectin,leptin,and ghrelin showed no significant difference between different gestational age groups (≤34 weeks group vs.＞ 34 weeks group).True insulin level of mature milk in 34 weeks group was higher than that of ＞ 34 weeks group (29.3 vs.21.6 mU/L,P =0.045) ; true insulin level in colostrums in ≤34 weeks group was lower than that in mature milk (21.7 vs.29.3 mU/L,P =0.000).Adiponectin levels in colostrum and 42 days weight gain were negatively correlated (r =-0.362,P =0.025).Insulin level in mature milk had a negative correlation with birth weight (r =-0.319,P =0.029).Ghrelin levels in colostrum and birth weight,length,head circumference,head circumference on 42nd day were positively correlated (r =0.271,0.261,0.360,P ＜ 0.05) ; weight,length at 42nd day and ghrelin levels showed borderline positive correlation (P =0.050,0.058).Conclusion Many bioactive hormones in milk might participate in the regulation of suitable growth after birth.Premature birth affects hormone levels in breast milk.Breast feeding is very important in preterm infants.
