配方营养素对母乳喂养婴儿骨密度和免疫球蛋白水平的影响研究

摘要

目的：探讨配方营养素对母乳喂养婴儿骨密度（ BMD ）和免疫球蛋白水平的影响。方法选取2012年1—5月在武义县妇幼保健院接生的婴儿74例，采用随机数字表法分为A （n＝25）、 B （n＝28）、 C （n＝21）3组， A组采取组方喂养方案（即母乳喂养联合配方营养素）， B组进行单纯性的母乳喂养， C组在母乳喂养的基础上补充外源性维生素D （VD）；分别于出生时及6、12月龄时，检测血清1，25-二羟维生素D3〔1，25（OH）2D3〕、免疫球蛋白（ IgA、 IgG、 IgM）水平及测定T细胞亚群（ CD3+、 CD4+、 CD8+）比例、 BMD水平，并进行比较分析。结果 A组婴儿6、12月龄时血清1，25（OH）2D3、 IgA、 IgG、 IgM水平和CD3+、 CD4+T淋巴细胞比例及BMD水平均高于B、C组，差异有统计学意义（P＜0.05）。 C组婴儿6月龄时血清1，25（OH）2D3、 IgA、 IgG、 IgM水平及CD3+、 CD4+T淋巴细胞比例均高于B组，12月龄时仅血清1，25（OH）2D3水平高于B组，差异有统计学意义（P＜0.05）；而6、12月龄时BMD水平与B组比较，差异均无统计学意义（P＞0.05）。结论单纯性的母乳喂养婴儿表现出较低的维生素水平和BMD；补充单一的VD虽然能够提高婴儿的血清1，25（OH）2D3水平，但对免疫球蛋白和BMD的作用相对受限；而配方营养素可同时提高婴儿的免疫球蛋白和 BMD水平，具有良好的应用前景。%Objective To explore the effect of formulated nutrients on bone mineral density and immunoglobulin level of breast-fed infants.Methods We enrolled 74 newborns in Maternal and Child Care Service Centre of Wuyi County .Using random number table method, the infants were divided into three groups: group A (n=25), group B (n=28) and group C (n=21) .The group A was fed with breast milk combined with formulated nutrients , the group B was purely fed with breast milk, and group C was fed with breast milk complemented with vitamin D .At birth, 6 months after and 12 months after, serum concentrations of 1, 25 (OH)2D3 and immunoglobulin (IgA, IgG, IgM) levels, T cell subsets (CD3 +、 CD4 +、 CD8 +) proportions and BMD level were detected and compared among the three groups .Results Group A was higher ( P<0.05 ) than group B and group C in 1, 25 (OH)2D3 serum concentration, levels of IgA, IgG and IgM, proportions of CD3 +and CD4 +T lymphocytes and BMD level 6 months and 12 months after birth.Group C was higher ( P <0.05 ) than group B in 1, 25 (OH)2D3 serum concentration, levels of IgA, IgG and IgM and proportions of CD3 +and CD4 +T lymphocytes 6 months after birth, and group C was higher ( P<0.05 ) than group B only in 1, 25 ( OH) 2 D3 serum concentration 12 months after birth; 6 and 12 months after birth, no significant difference was noted between group B and group C in BMD level (P>0.05). Gonclusion Infants fed with pure breast milk show lower BMD and vitamin level .Although the only supplement of Vitamin D can improve 1, 25 (OH)2D3 serum concentration in infants, its effect on bone mineral density and immunoglobulin level is relatively limited.Formulated nutrients could increase the immunoglobulin and BMD level and have a favorable application prospect .