Minimal enteral nutrient requirements for intestinal growth in neonatal piglets: how much is enough?
Minimal enteral nutrient requirements for intestinal growth in neonatal piglets: how much is enough?
复制标题
DOI：
10.1093/ajcn/71.6.1603
复制
发表时间：
2000-06
期刊：
影响因子：
--
通讯作者：
D. Burrin;B. Stoll;R. Jiang;X. Chang;B. Hartmann;J. Holst;G. Greeley;P. Reeds
中科院分区：
文献类型：
--
作者：
D. Burrin;B. Stoll;R. Jiang;X. Chang;B. Hartmann;J. Holst;G. Greeley;P. Reeds
肠外营养的早产儿通常接受最低限度的肠内喂养，目的是增强肠道功能。这种方案是否能增加肠道生长尚未确定。目的我们的目的是确定刺激和正常化新生儿肠道生长所需的最低肠内营养摄入量。方法新生猪给予等量的营养素溶液7 d，定量测定肠生长和细胞增殖。不同组（每组n = 5-7）肠内接受总营养摄入量的0%、10%、20%、40%、60%、80%或100%，其余通过胃肠外给予。结果：空肠湿重、蛋白质质量和绒毛高度在肠内摄入量> 40%时显著增加。刺激回肠蛋白质质量需要更高的肠内摄入量（60%）。在这两个部分，突然增加DNA质量，隐窝深度，鸟氨酸脱羧酶活性，并在S期隐窝细胞发生肠摄入量的40%和60%之间。胰高血糖素样肽-2和肽YY的循环浓度在40%和60%的肠内摄入量之间显著增加，而不是胃泌素，并且接近细胞增殖指数。结论：增加粘膜质量所需的最低肠内营养摄入量为总营养摄入量的40%，而维持正常粘膜增殖和生长所需的肠内营养摄入量为60%。我们的研究结果表明，提供<40%的总营养摄入肠内没有显着的肠道营养作用。
BACKGROUND Parenterally nourished preterm infants commonly receive minimal enteral feedings, the aim being to enhance intestinal function. Whether this regimen increases intestinal growth has not been established. OBJECTIVE Our objective was to determine the minimal enteral nutrient intakes necessary to stimulate and to normalize neonatal intestinal growth. METHODS Intestinal growth and cell proliferation were quantified in neonatal pigs given equal amounts of an elemental nutrient solution for 7 d. Different groups (n = 5-7 per group) received 0%, 10%, 20%, 40%, 60%, 80%, or 100% of total nutrient intake enterally, with the remainder given parenterally. RESULTS In the jejunum, wet weight, protein mass, and villus height were significantly greater at enteral intakes >40%. Stimulation of ileal protein mass required a higher enteral intake (60%). In both segments, abrupt increases in DNA mass, crypt depth, ornithine decarboxylase activity, and crypt cells in S-phase occurred between enteral intakes of 40% and 60%. Circulating concentrations of glucagon-like peptide-2 and peptide YY, but not gastrin, increased significantly between enteral intakes of 40% and 60% and closely paralleled indexes of cell proliferation. CONCLUSIONS The minimal enteral nutrient intake necessary to increase mucosal mass was 40% of total nutrient intake, whereas 60% enteral nutrition was necessary to sustain normal mucosal proliferation and growth. Our results imply that providing <40% of the total nutrient intake enterally does not have significant intestinal trophic effects.