母乳唾液酸与足月婴儿早期智能发育关系的研究

摘要

目的：探讨母乳唾液酸(sialic acid，SA)与足月婴儿早期智能发育的关系。方法：采用前瞻性队列研究，调查了100组母亲及其婴儿，生后3个月采用0~3岁婴幼儿智能发育量表(Children’s Development Center of China，CDCC)评价智能，得出智力发育指数(mental development index，MDI)和运动发育指数(psychomotive development index，PDI)。用酶联免疫吸附法测定3 d、42 d、3月的母乳和42 d、3月的婴儿随机尿SA水平。分析母乳SA与婴儿智能发育的关系。结果：80组对象数据完整，生后3 d、42 d、3月的母乳SA水平随时间逐渐下降(P<0.01)；42 d与3月婴儿随机尿SA水平差异无统计学意义。42 d时婴儿尿SA与母乳SA正相关(r=0.803，P<0.01)，而在3月时无相关性。3 d、42 d、3月的母乳SA与MDI的相关系数分别为0.708、0.408、0.594，P<0.01；与PDI的相关系数分别为0.661、0.455、0.471，P<0.01。婴儿按MDI与PDI分值分成高、中、低3组，比较3组间的三阶段母乳SA水平，发现智能高组母乳SA高，智能低组母乳SA低(P<0.05)。结论：母乳尤其是初乳SA水平与婴儿早期智能发育密切相关，提高乳母SA摄入量有益于婴儿早期智能发育。%Objective: To investigate the relationships between sialic acid(SA) of human milk and the early intellectual de-velopment of term infants. Methods: The present research was a prospective cohort study and 100 pairs of mothers-infants were recruited. All infants of 3 months old were evaluated by Children’s Development Center of China(CDCC) to obtain the mental and psycho-motor development index (MDI and PDI). All samples were collected from human milk at 3 days , 42 days and 3 months postpartum and random urine of infants at 42 days and 3 months after birth. SA levels were measured by en-zyme-linked immunosorbent assay to explore the correlation between SA levels of human milk at each time point and the ear-ly intellectual development of term infants. Results: Complete data was obtained from 80 pairs of puerperas-infants. As the elapse of time, SA levels of human milk were decreased significantly (P<0.01), while SA levels of infant random urine had no marked difference between 42 days and 3 months after birth. The positive correlation between SA levels of infant urine and human milk was only found at postnatal day 42. The positive associations were found between MDI and SA levels of human milk at 3 days, 42days and 3 months postpartum, then correlation coefficients were 0.708, 0.408 and 0.594 respectively(P<0.01), so were PDI, the correlation coefficients were 0.661, 0.455 and 0.471 respectively(P<0.01). The level of SA of human milk in relative higher score MDI group was higher than that in lower MDI group, and so was PDI. Conclusion:SA level of human milk, especially colostrum, is closely related to the early intellectual development of term infants, which could be improved by maternal more intake of SA.