探讨母乳中生长抑素(SST)及胃动素(MTL)含量变化与婴儿摄入母乳发生变态反应的相关性，旨在为进一步研究婴儿食物摄入导致变态反应的机制提供帮助。

选择2011年1月至2015年12月于四川大学华西第二医院消化儿科住院治疗，并且被确诊为因摄入母乳而发生变态反应的23例患儿为研究对象，纳入研究组。患儿摄入母乳发生变态反应的诊断标准为：纯母乳喂养患儿发生反复消化道症状，停止母乳摄入后症状消退，母乳再激发试验呈阳性。本研究组纳入标准：因消化道症状反复多次就诊的<6个月纯母乳喂养婴儿，符合母乳摄入导致变态反应的诊断标准。排除标准：消化道畸形、先天遗传性疾病及特殊病原体消化道感染者。按照随机数字表法随机选择同期于本院接受常规儿童保健的纯母乳喂养健康婴儿23例，纳入对照组。采集研究组与对照组受试者大便标本及摄入母乳标本，采用放射免疫测定(RIA)检测标本中生物活性成分SST与MTL含量，并进行统计学比较。研究组与对照组受试者性别构成比、年龄、体重及摄入母乳情况等比较，差异均无统计学意义(P>0.05)。本研究遵循的程序符合四川大学华西第二医院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试者监护人的知情同意，并与之签署临床研究知情同意书。

两组受试者摄入母乳中生物活性成分SST含量：研究组为(236.7±28.9)pg/mg，对照组为(412.6±36.7)pg/mg，研究组摄入母乳中SST含量显著低于对照组，并且差异有统计学意义(t＝2.821，P＝0.012)；摄入母乳中MTL含量：研究组为(159.4±36.7)pg/mg，对照组为(216.8±59.7)pg/mg，研究组摄入母乳中MTL含量显著低于对照组，并且差异亦有统计学意义(t＝2.517，P＝0.026)。两组受试者大便标本中SST含量：研究组为(32.6±8.9)pg/mg，对照组为(56.2±12.7)pg/mg，研究组大便标本中SST含量显著低于对照组，并且差异有统计学意义(t＝2.506，P＝0.029)；大便标本中MTL含量：研究组为(12.3±3.7)pg/mg，对照组为(21.6±4.7)pg/mg，研究组大便中MTL含量显著低于对照组，并且差异亦有统计学意义(t＝2.468，P＝0.031)。

胃肠肽是母乳中重要的生物活性成分。母乳中SST缺乏，可能通过降低食物免疫耐受机制，导致婴儿发生变态反应。母乳中MTL缺乏，可能促进婴儿对食物不耐受及消化功能异常发生。

To study the relations between allergy and change of somatostatin (SST) and motilin (MTL) in breast milk, so as to provide reference for further research of pathomechanism of food allergy in infants.

From January 2011 to December 2015, a total of 23 cases of infants who were diagnosed as allergic gastroenteritis because of pure breast feeding were included into research group. All the patients were hospitalized in Department of Gastrointestinal in West China Second University Hospital, Sichuan University. Diagnostic criteria for allergy of breast milk were repeated alimentary symptoms which would release when stop breast feeding, and rechallenge test of breast milk induced the same symptoms. Inclusion criteria for allergic gastroenteritis infants in research group included: younger than 6 months of exclusive breastfeeding infants who visited medical clinic frequently as digestive disorders, and exclusion criteria were alimentary malformation, hereditary diseases and gastrointestinal infection of specific pathogen. During the same time and in the same hospital, a total of 23 cases of normal infants with pure breast feeding were collected as control group. Samples of their breast milk and stools were collected in two groups. Levels of SST and MTL in breast milk and stools were detected by radioimmunoassay (RIA). There were no significant differences between two groups among gender ratios, age and weight, breast-feeding practices, etc. (P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Informed consent was obtained from the parents of each participating infant.

Level of SST in breast milk was (236.7±28.9) pg/mg in research group, and (412.6±36.7) pg/mg in control group, level of SST in research group was much lower than that in control group, and there was significant difference between two groups (t=2.821, P=0.012). Level of MTL in breast milk was (159.4±36.7) pg/mg in research group, and (216.8±59.7) pg/mg in control group, level of MTL in research group was much lower than that in control group, and there was significant difference between two groups (t=2.517, P=0.026). Level of SST in stool sample was (32.6±8.9) pg/mg in research group, and (56.2±12.7) pg/mg in control group, level of SST in research group was much lower than that in control group, and there was significant difference between two groups (t=2.506, P=0.029). Level of MTL in stool sample was (12.3±3.7) pg/mg in research group, and (21.6±4.7) pg/mg in control group, level of MTL in research group was much lower than that in control group, and there was significant difference between two groups (t=2.468, P=0.031).

Gastrointestinal peptides are also important bioactive components in breast milk. Deficiency of SST in breast milk may decrease immunotolerance of food, and contribute to allergy. Deficiency of MTL in breast milk may helps to induce food intolerance and functional dyspepsia.