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Gastrointestinal absorption and protein energy metabolism in infants with chronic lung disease

慢性肺病婴儿的胃肠吸收和蛋白质能量代谢

基本信息

批准号：
09671197
负责人：
TAKEUCHI Toshio
金额：
$ 1.02万
依托单位：
Showa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1998
项目状态：
已结题

项目摘要

Undernutrition and growth failure in infants with chronic lung disease (CLD) remains one of the major clinical problems for pediatricians, but the cause is unknown. Recent reports showed that undernutrition is a major contributing factor in the pathogenesis of CLD. We measured the energy metabolism and the activities of lipase and trypsin in aspirated duodenal juice of very low birth weight infants (VLBWI) with and without CLD. To examine the difference in energy metabolism of 13 VLBWI (6 cases with CLD, 7cases without CLD), a metabolic gas monitor (MGM/jr.) was used to obtain oxygen consumption and carbon dioxide production. Oxygen consumption (9.9±1.3 versus 8.5±1.1 ml/kg/min : p<0.05), and energy expenditure (71.6±10.3 versus 61.1±7.9 kcal/kg/day : p<0.05) were higher in infants with CLD. Total energy intake ( 80.2±11.9 versus 98.2±7.9 kcal/kg/day : p<0.01) was lower in infants with CLD. The activities of lipase and trypsin were measured in preprandially aspirated duodenal juice of 20 VLBWI during 8 weeks of postnatal period. The activities of both enzymes significantly increased with postnatal age. These 20 infants were allocated into two groups according to oxygen supplemented period and ventilatory supported period. The pancreatic enzyme activity of the infants who needed longer OィイD22ィエD2 supplementation and ventilatory support were lower than the others. From these results, we concluded that careful and individual nutritional management was needed in the VLBW infants with CLD who require long term ventilatory supports.

慢性肺病（CLD）婴儿的营养不良和生长障碍仍然是儿科医生面临的主要临床问题之一，但原因尚不清楚。最近的报告表明，营养不良是慢性肝病发病机制的主要因素。我们测定了极低出生体重儿（VLBWI）伴和不伴CLD的十二指肠液中能量代谢和脂肪酶、胰蛋白酶活性。为探讨13例VLBWI（CLD组6例，非CLD组7例）能量代谢的差异，采用MGM/jr.用于获得氧气消耗和二氧化碳产生。CLD婴儿的耗氧量（9.9±1.3 vs 8.5±1.1 ml/kg/min：p<0.05）和能量消耗（71.6±10.3 vs 61.1±7.9 kcal/kg/d：p<0.05）较高。CLD婴儿的总能量摄入量（80.2±11.9与98.2±7.9 kcal/kg/d：p<0.01）较低。对20例VLBWI生后8周的十二指肠液进行脂肪酶和胰蛋白酶活性测定。这两种酶的活性显着增加与出生后的年龄。按吸氧期和呼吸支持期分为两组。补充O β D22、D β D2和排便支持时间较长的婴儿胰腺酶活性较低。根据这些结果，我们得出结论，需要长期营养支持的CLD极低出生体重婴儿需要仔细和个性化的营养管理。