Dietary protein absorption of the small intestine in human neonates
Dietary protein absorption of the small intestine in human neonates
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DOI：
10.1177/0148607107031006482
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发表时间：
2007-11-01
影响因子：
3.4
通讯作者：
van Goudoever, Johannes B.
中科院分区：
文献类型：
--
作者：
Schaart, Maaike W.;de Bruijn, Adrianus C. J. M.;van Goudoever, Johannes B.
背景：肠道在新生儿对膳食蛋白质的吸收中起着关键作用，而膳食蛋白质的吸收决定着新生儿的生长发育。新生儿期的肠切除会导致吸收和保护表面的丧失，从而可能导致膳食营养素吸收不良。然而，没有关于人类新生儿肠道手术后小肠净膳食蛋白吸收的数据。因此，我们评估了饮食喂养耐受性和定量的净饮食蛋白质吸收能力的人新生儿的小肠中，在临时空肠或回肠造口。方法：17例患者纳入研究。术后第3 ~ 6周，我们每周在肠造口水平收集小肠流出液，持续24-48小时。肠流出液中的蛋白质水平通过二辛可宁酸（BCA）测定来确定。结果：14例患者在术后中位17天（范围，8-32天）达到肠内摄入量>100 mL/kg/d。3例患者在研究期间未达到该水平。总的来说，膳食蛋白质净吸收能力为总肠内蛋白质摄入量的70%-90%。结论：这项研究表明，小肠的膳食蛋白质吸收能力是完整的，在大多数人类新生儿肠道手术后，在一个非常关键的时期，他们的生活。此外，我们的研究结果不支持使用水解或元素配方在新生儿肠造口术，以提高氨基酸的吸收。
Background: The intestine plays a key role in the absorption of dietary proteins, which determines growth of human neonates. Bowel resection in the neonatal period brings loss of absorptive and protective surface and may consequently lead to malabsorption of dietary nutrients. However, there are no data on net dietary protein absorption of the small intestine in the period after intestinal surgery in human neonates. We therefore evaluated dietary feeding tolerance and quantified net dietary protein absorption capacity of the small intestine in human neonates in whom a temporary jejunostomy or ileostomy was created. Methods: Seventeen patients were included in the study. We collected small intestinal outflow fluid at the level of the enterostomy weekly for 24-48 hours during weeks 3 through 6 postoperatively. Protein levels in the intestinal outflow fluid were determined by bicinchoninic acid (BCA) assay. Results: In 14 patients, an enteral intake of >100 mL/kg/d was reached at a median of 17 days (range, 8-32 days) postoperatively. Three patients did not reach this level within the study period. Overall, the net dietary protein absorption capacity was 70%-90% of the total enteral protein intake. Conclusions: This study demonstrates that the dietary protein absorption capacity of the small intestine is intact in most human neonates after intestinal surgery in a very critical period of their lives. Furthermore, our results do not support the use of hydrolyzed or elemental formula in newborns with an enterostomy to improve amino acid uptake.