Clarification of etiology of neonate and infant vitamin K deficiency

众所周知，新生儿和婴儿缺乏维生素K会导致新生儿黑黑症和颅内出血性疾病。这些疾病在母乳喂养的婴儿中比在奶瓶喂养的婴儿中更常见，但原因尚不清楚。关于如何防止婴儿维生素K缺乏症，有一些建议。另一方面，测定内源性K族维生素（叶绿醌：K1和甲基萘醌：MK-4， mk - 1, MK-7）在人血浆中的浓度是非常困难的。本研究首先报道了胎盘中维生素K1、MK-4、mk - 1、MK-7的薄层色谱分离测定方法，然后采用高效液相色谱法（HPLC）和柱后化学还原荧光法测定。在母体和脐带血浆中采用高效液相色谱法和荧光法测定，在柱后电化学还原母体和脐带血浆中采用高效液相色谱法和荧光法测定。接下来，我们描述维生素k在不同组织中的可用性。在胎盘和母体血浆中发现维生素K1和MK-4、MK-6和MK-7，在母乳和羊膜中发现大量维生素K1和MK-48，少量维生素mk - 1和MK-7，在脐带血浆、羊膜液、胎粪和干酪皮脂中发现维生素K1和MK-4。第三，为了预防新生儿早期出血性疾病，我们在分娩前给母亲静脉注射或口服维生素K2药物，发现与未治疗的母亲组相比，脐带血浆、分娩时母体血浆和分娩后5天母乳中的维生素k浓度明显较高。因此，在分娩前口服或静脉给药维生素Ks药物，使维生素Ks从母亲早期和持续地转移到新生儿中，比肌肉注射给新生儿更安全，更可取，但有一定的危险性。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