Ozmert E, Yurdakök K, Aslan D, Yalçin S S, Yardim M
Hacettepe University Institute of Child Health, Department of Social Pediatrics, Ankara, Turkey.
Acta Paediatr. 1999 Oct;88(10):1071-3. doi: 10.1080/08035259950168108.
Transient glucose intolerance (TGI) is an important cause of WHO G-ORS (Glucose-Oral Rehydration Solution) treatment failure and hospitalization in dehydrated children during acute diarrhoea. This retrospective case-control study was designed to determine some risk and predictive factors for developing TGI among moderately dehydrated patients with acute diarrhoea while under G-ORS therapy. Among moderately dehydrated patients, files of 22 patients with TGI and 66 other dehydrated patients without intolerance were reviewed. Patients with TGI were younger (9.7+/-10.5 mo and 11.6+/-7.8 mo, respectively, p < 0.05), the median age being 6 mo in the TGI group and 10 mo in non-TGI group. There was no difference between groups for sex, admission season, history of fever or vomiting, frequency of vomiting, presence of blood, mucous or leukocyte in stool, presence of associated disease and duration of diarrhoea on admission. The admission haemoglobin, white blood cell, blood pH, sodium and potassium levels were similar in both groups. The mean serum chloride level (116.8+/-6.9, 109.6+/-7.9 mEq/l, respectively, p<0.05) was higher in the TGI group and the bicarbonate level was lower (12.9+/-3.8, 15.3+/-6.0, respectively, p < 0.05). Stool frequency was also higher in patients with TGI (11.2+/-5.3/24 h, 5.9+/-4.4/24 h, respectively, p < 0.05). No difference was found between the nutritional status of children in both groups. More children were breastfed in the group without TGI (34/56, 61%, 6/18, 33% respectively, p=0.079, OR=0.32, 95% CI [0.09-1.11]). It was concluded that patients with TGI are younger and have high stool frequency. Although statistical significance could not be shown, breastfeeding seems to protect children from TGI, as it protects from diarrhoea.
短暂性葡萄糖不耐受（TGI）是世界卫生组织口服补液盐（G-ORS）治疗失败以及急性腹泻脱水儿童住院治疗的一个重要原因。这项回顾性病例对照研究旨在确定急性腹泻中度脱水患者在接受G-ORS治疗期间发生TGI的一些风险因素和预测因素。在中度脱水患者中，对22例TGI患者和66例其他无不耐受的脱水患者的病历进行了回顾。TGI患者年龄更小（分别为9.7±10.5个月和11.6±7.8个月，p<0.05），TGI组的中位年龄为6个月，非TGI组为10个月。两组在性别、入院季节、发热或呕吐史、呕吐频率、粪便中是否有血液、黏液或白细胞、是否存在相关疾病以及入院时腹泻持续时间方面没有差异。两组入院时的血红蛋白、白细胞、血液pH值、钠和钾水平相似。TGI组的平均血清氯水平较高（分别为116.8±6.9、109.6±7.9 mEq/l，p<0.05），碳酸氢盐水平较低（分别为12.9±3.8、15.3±6.0，p<0.05）。TGI患者的排便频率也更高（分别为11.2±5.3次/24小时、5.9±4.4次/24小时，p<0.05）。两组儿童的营养状况没有差异。非TGI组母乳喂养的儿童更多（分别为34/56，61%；6/18，33%，p=0.079，OR=0.32，95%CI[0.09-1.11]）。得出的结论是，TGI患者年龄更小且排便频率高。虽然未显示出统计学意义，但母乳喂养似乎能像预防腹泻一样保护儿童免受TGI的影响。
