Clarification of etiology of neonate and infant vitamin K deficiency

众所周知，新生儿和婴儿维生素K缺乏会导致新生儿黑便和颅内出血性疾病。这些疾病在母乳喂养的婴儿中比在奶粉喂养的婴儿中更常见，但原因仍不清楚。关于如何防止婴儿患上维生素K缺乏症，一直有一些建议。另一方面，测定人血浆中K类维生素(叶醌：K1和菜醌：MK-4、MK-L、MK-7)的浓度是非常困难的。本研究首先报道了用薄层层析法对胎盘中维生素K1、MK-4、MK-L、MK-7的分离和测定方法，然后用柱后化学还原后的高效液相色谱法和荧光法测定了母体和脐带血浆中的维生素K1和MK-4、MK-L和MK-7，然后用高效液相色谱法和荧光法测定了母体和脐带血浆中的柱后电化学法和荧光测定仪…更多的是铂还原柱。接下来，我们描述维生素Ks在不同组织中的可获得性。胎盘和母体血浆中含有维生素K1和MK-4、MK-6和MK-7，母乳和羊膜中含有较多的K1和MK-48和少量的MK-L和MK-7，脐带血浆、羊水和羊膜中含有K1和MK-4。第三，为了预防新生儿早期出血性疾病，我们静脉注射维生素K2药物。与未治疗组比较，未治疗组脐血、母体出生时血浆及产后5天母乳中维生素K_s浓度均显著升高。因此，口服或静脉注射。母亲在分娩前给予维生素Ks药物，导致维生素Ks从母亲早期持续转运到新生儿身上，比肌肉注射新生儿更安全、更可取，因为肌肉注射会有一定的危险。较少

It is well known that neonatal and infantile vitamin K deficiency causes melena neonatorumand intracranial hemorrhagic disorders. These disorders occur more frequently in breast-fed babies than in bottle fed babies, but the reason is still obscure. There have been some suggestions as to how to prevent babies from having vitamin K deficiency. On the other hand, determination of endogenous concentrations of the K vitamins (phylloquinone:K1 and menaquinones:MK-4, MK-l, MK-7)in human plasma is very difficult. In this study, at first we report clear separations and determination methods of vitamins K1 and MK-4, MK-l and MK-7 in placenta with the use of thin layer chromatography, followed by high performance liquid chromatography(HPLC) and fluorometric determination after post-column chemical reduction, in maternal and umbilical cord plasma by HPLC and fluorometric determination follwed post-column electochemical reduction in maternal and umnilical cord plasma by HPLC and fluorometric determ … More ination follwed platinum reduction column. Next, we describe the availability of vitamin Ks in different tissues. Vitamins K1 and MK-4, MK-6 and MK-7 were found in placenta, and maternal plasma, much K1 and MK-48 and slightly MK-l and MK-7 were found in breast milk and amniotic membrance, and K1 and MK-4 were found in umbilical cord plasma, smniotic luid, meconium and vernix caseosa. Third, to prevent early hemorrhagic diseases of the newborn, we have administered vitamin K2 drug by i.v. or oral route to mother before delivery, and vtaimin Ks concentrations in umbilival cord plasma, maternal plasma at birth and breast milk of 5 days after delivery were found to be siginficantly high as ccompared with those of non-treated mothers group. Therefore, oral or i.v. administration of vitamin Ks drug to mother before delivery which causes early and continuos transportation of vitamin Ks from mother to neonate is safer and more preferable than intramusclar injection to neonate, whic involves a certain degree of danger. Less