母乳β-葡萄糖醛酸苷酶与母乳性黄疸的关系

Relationship between Breast Milk Beta-Glucuronidase and Breast Milk Jaundice

目的探讨母乳β-葡萄糖醛酸苷酶(-βGD)活性在母乳性黄疸(BMJ)发病机制中的作用。方法对14例BMJ患儿停母乳,改配方乳喂养3 d,后继续哺煮沸后母乳(灭活乳)3 d。于哺配方奶前、哺配方奶3 d末、哺灭活乳3 d末,分别采集不同乳类和粪便,测定-βGD活性,同时测定血清胆红素浓度。结果1.母乳-βGD活性为(87.60±44.67)U/mL,配方乳为(2.99±2.67)U/mL,灭活乳为(2.76±2.03)U/mL;母乳-βGD活性与配方乳和灭活乳比较均有非常显著差异(P均<0.001);配方乳β-GD活性与灭活乳比较无显著差异(P>0.05)。2.于哺配方乳前、哺配方乳3 d末、哺灭活乳3 d末,测定粪便-βGD活性分别为(310.12±131.98)、(326.86±138.26)和(337.91±143.21)U/g,组间无显著差异(F=0.033 P>0.05)。3.继续哺灭活乳患儿血清胆红素浓度持续下降,无1例出现反弹。结论1.母乳-βGD不是肠道内-βGD的主要来源,可能与BMJ发生关系不大。2.母乳中的一些加热可灭活因子可能与BMJ发生有关。

Objective To study the relationship between breast milk beta - glucuronidase （β - GD） and breast milk jaundice（BMJ）. Methods Forteen infants with BMJ, breast feeding was stopped to be fed with infant formula for 3 days, subsequently, inactivated breast milk for 3 days. The β- GD activity was estimated in the different sorts of milk and inactivated breast milk） and infant feces. ,Samples were collected before bottle feeding, by the end of bottle feeding and inactivated breast feeding. The β - GD assay was performed by using phenolphthalein - mono - glucumnic acid subatrate serum bilirubin concentration was determined at the same time. Results 1. β - GD activity of breast milk, infant formula and inactivated breast milk were （87.60 ± 44.67）, （2.99 ± 2.67）, and （2.76 ± 2.03） U/mL, respectively. β- GD.activity of breast milk was significantly higher than that of infant formula or inactivated breast milk,and there was significantly difference between them（ P 〈 0. 001 ）, there was no significant difference between infant formula and inactivated breast milk β- GD activity （P〉0, 05）. 2. Infant fecal β- GD activity before bottle feeding, by the end of bottle feeding and inactivated breast feeding were （310. 12 ± 131.98）, （326.86 ± 138.26）, （337.91 ± 143.21 ） U/g, respectively, there were no significant difference among them（ F = 0. 033 P〉0.05）, 3. The bilirubin level didn＇t rebound when inactivated breast milk was fed. Conclusions 1. β - GD of breast milk is not a main source in the intestinal tract, and β - GD of breast milk is not related to the development of BMJ. 2, Some factors inactivated by boiling in breast milk may be related to the development of BMJ.