發(fā)布時(shí)間：2018-01-02 00:07

  本文關(guān)鍵詞：母乳營(yíng)養(yǎng)成分含量的測(cè)定　出處：《蘇州大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 母乳 初乳 過渡乳 成熟乳 蛋白質(zhì) 脂肪 乳糖 礦物質(zhì) 水份 能量 密度 膳食攝入

【摘要】：目的：探討母乳分析儀(Human Milk Analyzer,HMA)測(cè)定母乳中各營(yíng)養(yǎng)成分含量可行性；了解母乳中各營(yíng)養(yǎng)成分在不同泌乳期的含量，同時(shí)研究母乳中各營(yíng)養(yǎng)成分含量的影響因素以及與乳母膳食之間的關(guān)系，為提高母乳質(zhì)量和指導(dǎo)母乳喂養(yǎng)提供科學(xué)依據(jù)。 方法：根據(jù)知情同意、自愿參加的原則，隨機(jī)抽取產(chǎn)后1天至9個(gè)月的乳母進(jìn)行橫向調(diào)查，采集母乳標(biāo)本，統(tǒng)一采用“宏揚(yáng)HMA2000型母乳分析儀”測(cè)定母乳標(biāo)本各營(yíng)養(yǎng)成分含量，進(jìn)行母乳分析儀誤差控制實(shí)驗(yàn)；同時(shí)對(duì)入選乳母進(jìn)行一般人口學(xué)資料及孕期和哺乳期生活情況進(jìn)行調(diào)查，并進(jìn)行乳母膳食調(diào)查。 結(jié)果：（1）母乳分析儀測(cè)定蛋白質(zhì)、脂肪、乳糖、礦物質(zhì)、水份、能量、密度的最低檢測(cè)限依次為0.30g/L、2.20g/L、2.00g/L、0.06g/L、708.70g/L、120.87kj、1.001kg/m~3，最高檢測(cè)限依次為29.90g/L、99.40g/L、186.10g/L、5.40g/L、1000.00g/L、1540.16kj、1.076kg/m3；精密度相對(duì)標(biāo)準(zhǔn)偏差（the relative standard deviation，RSD）依次為0.43%、0.70%、0.45%、0.31%、0.15%、0.53%、0.00%；重復(fù)性RSD依次為1.75%、0.53%、1.81%、1.74%、0.23%、3.79%、0.08%；蛋白質(zhì)、脂肪、乳糖、礦物質(zhì)的平均回收率分別為95.46%、99.18%、95.38%、95.27%。母乳樣品在16℃常溫保存48h，脂肪、水分、密度三組數(shù)據(jù)的差異有統(tǒng)計(jì)學(xué)意義，而蛋白質(zhì)、乳糖、礦物質(zhì)三組數(shù)據(jù)的差異無統(tǒng)計(jì)學(xué)意義。母乳樣品在4℃冷藏保存180h，蛋白質(zhì)、脂肪、乳糖、礦物質(zhì)、水分、密度六組數(shù)據(jù)的差異均無統(tǒng)計(jì)學(xué)意義。（2）37份初乳、32份過渡乳、161份成熟乳中的蛋白質(zhì)依次為13.03±1.00g/L、12.30±0.75g/L、11.29±0.84g/L；脂肪依次為26.17±14.11g/L、41.41±14.71g/L、44.56±1.67g/L；乳糖依次為81.04±6.23g/L、76.43±4.71g/L、70.24±2.10g/L；礦物質(zhì)依次為2.27±0.17g/L、2.32±0.13g/L、1.96±0.35g/L；水份依次為877.49±13.47g/L、867.72±13.14g/dl、872.42±7.38g/dl；能量依次265.277±53.185kj、317.21±54.51kj、317.10±64.99kj；密度均值為1.033±0.003kg/m3、1.030±0.003kg/m~3、1.027±0.003kg/m~3。（3）母乳各營(yíng)養(yǎng)成分含量與不同嬰兒月齡的變化關(guān)系：母乳中蛋白質(zhì)含量的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=-0.2034*x+12.278；脂肪含量的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=1.5378*x+36.90；乳糖含量的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=-1.2739*x+76.373；礦物質(zhì)含量的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=-0.0354*x+2.133；水份的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=0.0914*x+872.33；能量的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=3.5611*x+298.9；密度的測(cè)定值（y）與嬰兒月齡（x）的變化關(guān)系為y=-0.0007*x+1.0301。（4）在產(chǎn)后體重減輕、孕后體重增加、產(chǎn)前體重、生育年齡、職業(yè)、家庭類型、嬰兒大便次數(shù)不同組內(nèi)的母乳中蛋白質(zhì)、乳糖、礦物質(zhì)含量均有顯著性差異（P均＜0.05）；產(chǎn)后體重減輕中，＞10kg組初乳中的蛋白質(zhì)、乳糖均顯著高于7-10kg組和＜7kg組；＞10kg組和7-10kg組初乳中的礦物質(zhì)均顯著高于＜7kg組。孕后體重增加中，＞19kg組的過渡乳中的蛋白質(zhì)、乳糖、礦物質(zhì)含量顯著高于11-19kg組；11-19kg組、＞19kg組的成熟乳中的蛋白質(zhì)、乳糖、礦物質(zhì)顯著高于7-10kg組。產(chǎn)前體重中，≥75kg組的過渡乳中的蛋白質(zhì)、乳糖、礦物質(zhì)顯著高于＜66kg組、66-74kg組。乳母生育年齡中，30-40歲組的初乳中的的蛋白質(zhì)、乳糖、礦物質(zhì)均顯著高于26-29歲組、≤25歲組。職業(yè)中，文職組的過渡乳中的蛋白質(zhì)、乳糖、礦物質(zhì)顯著高于非文職組。家庭類型中，主干家庭組的初乳中蛋白質(zhì)、乳糖、礦物質(zhì)含量高于非主干家庭組。在家庭總月收入、家庭總?cè)丝跀?shù)不同組內(nèi)的母乳中脂肪含量均有顯著性差異（P均＜0.05）。家庭總月收入中，＜3千元組的成熟乳中脂肪顯著高于3-8千元組。家庭總?cè)丝跀?shù)中，，＜5人組的成熟乳中脂肪含量均顯著高于≥5人組。嬰兒大便次數(shù)中，≥5次組的成熟乳的蛋白質(zhì)、乳糖顯著高于＜1次組。（5）乳母膳食攝入能量在成熟乳的蛋白質(zhì)、乳糖、礦物質(zhì)的高成分組與低成分組之間進(jìn)行比較，具有顯著性統(tǒng)計(jì)學(xué)差異(P均＜0.01)；乳母膳食攝入蛋白質(zhì)在成熟乳的乳糖的高成分組與低成分組之間進(jìn)行比較，可見顯著性差異（P＜0.05）；乳母膳食攝入脂肪在成熟乳的蛋白質(zhì)、礦物質(zhì)高成分組與低成分組之間進(jìn)行比較，均具有顯著性統(tǒng)計(jì)學(xué)差異（P均＜0.05）；乳母膳食攝入碳水化合物在脂肪的高成分組與低成分組之間進(jìn)行比較，可見顯著性統(tǒng)計(jì)學(xué)差異（P＜0.05）。 結(jié)論：（1）母乳分析儀具有精密度高、重復(fù)性良好、測(cè)定過程樣品損失少、母乳經(jīng)4℃冷藏7天穩(wěn)定性較好的特性，可作為一種快速簡(jiǎn)單檢測(cè)母乳營(yíng)養(yǎng)成分的工具。（2）母乳中的蛋白質(zhì)、乳糖、礦物質(zhì)、密度隨著泌乳期的延長(zhǎng)而減少；而脂肪、能量、水份隨月齡增加而增多，適應(yīng)嬰兒生長(zhǎng)發(fā)育的需求。（3）有利于增加蛋白質(zhì)、乳糖、礦物質(zhì)含量的因素是乳母生育年齡處于30-40歲之間、從事文職工作、主干家庭類型、孕后體重增加越多、產(chǎn)前體重越重、產(chǎn)后體重減輕越多等；而母乳中脂肪含量下降的有關(guān)因素則是高月收入家庭、家庭總?cè)丝跀?shù)多于5人等。母乳中乳糖含量越高，則嬰兒大便次數(shù)越多。（4）在成熟乳中，乳母的高能量飲食可增加蛋白質(zhì)、乳糖和礦物質(zhì)含量，高蛋白飲食可增加乳糖含量，高脂肪飲食則可增加蛋白質(zhì)和礦物質(zhì)含量，高碳水化合物飲食可促進(jìn)脂肪含量。
[Abstract]:Objective: To investigate the breast milk analyzer (Human Milk Analyzer, HMA) for determination of content of nutritional ingredients feasibility in breast milk; understand the nutrients content in breast milk in different lactation period, the relationship between influence factors and research content of nutritional components in human milk and lactating women, to provide scientific basis for improving the quality of breast milk and breast-feeding guidance.
Methods: according to the informed consent, the principle of voluntary participation, randomly selected from 1 days to 9 months postpartum nurse horizontal survey, collected milk samples, measured by the unified milk samples of the nutrient content of developing type HMA2000 breast milk analyzer, analyzer error control experiment; at the same time, the selected nurse survey of general demographic data and during pregnancy and lactation life, and thelastria dietary survey.
Results: (1) the determination of protein, milk fat analyzer, lactose, minerals, water, energy, the minimum detection limit of density were 0.30g/L, 2.20g/L, 2.00g/L, 0.06g/L, 708.70g/L, 120.87kj, 1.001kg/m~3, the highest detection limit were 29.90g/L, 99.40g/L, 186.10g/L, 5.40g/L, 1000.00g/L, 1540.16kj, 1.076kg/m3; precision relative standard deviation (the relative standard deviation, RSD) were 0.43%, 0.70%, 0.45%, 0.31%, 0.15%, 0.53%, 0%; repeatability of RSD were 1.75%, 0.53%, 1.81%, 1.74%, 0.23%, 3.79%, 0.08%; protein, fat, lactose, minerals, the average recovery rate was 95.46%, 99.18%, 95.38%, 95.27%. the milk samples stored at 16 C ambient temperature 48h, fat, moisture, a statistically significant difference on density of three data sets of protein, lactose, minerals had no significant difference between the three groups of data. Breast milk samples were refrigerated at 4 C for 180h protein Soft, fat, lactose, minerals, water, the density difference data of the six groups were not statistically significant. (2) 37 copies of 32 copies of colostrum, transitional milk, 161 samples of mature milk protein were 13.03 + 1.00g/L, 12.30 + 0.75g/L, 11.29 + 0.84g/L; fat were 26.17 + 14.11g/L, 41.41 + 14.71g/L 44.56 + 1.67g/L; in turn, lactose was 81.04 + 6.23g/L, 76.43 + 4.71g/L, 70.24 + 2.10g/L; minerals were 2.27 + 0.17g/L, 2.32 + 0.13g/L, 1.96 + 0.35g/L; the water was 877.49 + 13.47g/L, 867.72 + 13.14g/dl, 872.42 + 7.38g/dl; energy were 265.277 + 53.185kj, 317.21 + 54.51kj, 317.10 + 64.99kj; the average density was 1.033 + 0.003kg/m3,1.030 + 0.003kg/m~3,1.027 + 0.003kg/m~3. (3) changes in the relationship between the nutrient content of breast milk with different months of age infants: Determination of protein content in human milk (y) and the months of age (x) the relationship between y=-0.2034*x+1 2.278; Determination of fat content (y) and the months of age (x) variation of y=1.5378*x+36.90; Determination of lactose content (y) and the months of age (x) the relationship between y=-1.2739*x+76.373; measured value of mineral content (y) and the months of age (x) the relationship between y=-0.0354*x+2.133 determination of moisture value; (y) and the months of age (x) variation is y=0.0914*x+872.33; the measured value of energy (y) and the months of age (x) variation of y=3.5611*x+298.9; Determination of density (y) and the months of age (x) between y=-0.0007*x+1.0301. (4) reduced in postpartum weight, weight increase after pregnancy, prenatal weight, age, occupation, family type, milk protein, stool frequency of infant in different groups of lactose and mineral content were significantly different (P < 0.05); postpartum weight loss, "10kg group in the colostrum milk protein. Sugar was significantly higher than that of 7-10kg group and 7kg group < > 10kg; and group 7-10kg in the colostrum minerals were significantly higher than those in 7kg group. The weight increase after pregnancy, "transitional milk group 19kg of protein, lactose, minerals were significantly higher than those in 11-19kg group; 11-19kg group, 19kg group, mature milk in the protein, lactose, minerals were significantly higher than that of 7-10kg group. Prenatal weight, more than 75kg group in transition milk protein, lactose, minerals was significantly higher than that of" group 66kg, 66-74kg group. In the women of childbearing age, the age group of 30-40 colostrum protein, lactose, minerals were significantly higher than those in the 26-29 age group, less than 25 age group. Occupation, civilian groups in the transitional milk protein, lactose, minerals were significantly higher than those of non civilian groups. The family type, the protein, the backbone of the family group in colostrum lactose, mineral content is higher than that of the non stem family group. In total household income, total household population The number of different content of fat in milk group was significant difference (P < 0.05). The total family income, < 3 thousand tuple in mature milk fat was significantly higher than that of 3-8 thousand tuples. The total population in the family, "the group of 5 in mature milk fat content was significantly higher than that of more than 5 people. The baby stool frequency, more than 5 groups of mature milk protein, lactose was significantly higher than that of < 1 times. (5) maternal dietary energy intake of mature milk protein, lactose, minerals high group and low group between comparison, statistically significant differences (P < 0.01); nurse the dietary protein intake in mature milk lactose into high group and low group between comparison, significant difference is observed (P < 0.05); thelastria dietary fat intake in mature milk protein, minerals high group and low group between comparison, were statistically significant The difference (P < 0.05); thelastria dietary intake of carbohydrates in the fat between the high group and low group were compared, showed significant statistical differences (P < 0.05).
Conclusion: (1) milk analyzer with high precision, good repeatability, determination of sample loss, breast milk is 4 DEG C refrigerated for 7 days with good stability properties, can be used as a rapid and simple detection of breast milk nutrients. (2) in breast milk protein, lactose, minerals, the density decreased with the prolonged lactation; fat, energy, water and increased with the increasing of age, adapt to the infant's growth and development needs. (3) to increase the protein, lactose, minerals of the factors are the nurse family at the age of 30-40 years, the work in civilian, the backbone of the family type, the more weight increase after pregnancy, prenatal the more weight, postpartum weight loss; related factors and fat content in breast milk decreased is high monthly household income, total household population of more than 5 people. The higher the content of lactose in milk, stool frequency of infant is more (4) in mature. Milk, high energy diet during lactation can increase the protein, lactose and mineral content, high protein diet can increase the content of lactose, high fat diet can increase the protein and mineral content, high carbohydrate diet can promote fat content.

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R174.4

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