Galpin Lauren, Manary Mark J, Fleming Katherine, Ou Ching-Nan, Ashorn Per, Shulman Robert J
Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
Am J Clin Nutr. 2005 Nov;82(5):1040-5. doi: 10.1093/ajcn/82.5.1040.
Tropical enteropathy is an asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. The histology of tropical enteropathy resembles that seen in small-bowel bacterial overgrowth.
This study tested the hypothesis that treatment of 3-5-y-old Malawian children with the probiotic Lactobacillus GG would improve their intestinal function and integrity.
Clinically healthy children (n = 164) were enrolled in a placebo-controlled, randomized, double-blind trial. Intestinal function and integrity were measured by using the site-specific sugar-absorption test before and after 30 d of treatment with Lactobacillus GG or placebo. The primary outcomes were the ratios of urinary lactulose to mannitol (L:M) and of urinary sucrose to lactulose (S:L) excretion.
Of the 161 children who completed the study, 119 (73%) had tropical enteropathy on enrollment (L:M > 0.10). Children receiving Lactobacillus GG did not differ significantly from the placebo group in the excretion (in % of dose administered) of mannitol (mean +/- SD: 8.9 +/- 4.4 and 8.9 +/- 3.9, respectively), lactulose (0.31 +/- 0.20 and 0.33 +/- 0.23, respectively), or sucrose (0.078 +/- 0.058 and 0.082 +/- 0.075, respectively). L:M and S:L also did not differ significantly between the Lactobacillus and placebo groups (0.19 +/- 0.13 and 0.20 +/- 0.12, respectively, for L:M; 0.58 +/- 0.46 and 0.65 +/- 0.57, respectively, for S:L).
Administration of Lactobacillus GG for 30 d had no effect on the intestinal integrity of 3-5-y-old Malawian children.
热带肠病是一种发生在发展中世界的无症状性小肠绒毛萎缩，与肠道功能和完整性改变有关。热带肠病的组织学表现与小肠细菌过度生长相似。
本研究检验了用益生菌鼠李糖乳杆菌GG治疗3至5岁马拉维儿童可改善其肠道功能和完整性这一假设。
将临床健康儿童（n = 164）纳入一项安慰剂对照、随机、双盲试验。在使用鼠李糖乳杆菌GG或安慰剂治疗30天前后，通过位点特异性糖吸收试验测量肠道功能和完整性。主要结局指标是尿中乳果糖与甘露醇（L:M）以及尿中蔗糖与乳果糖（S:L）的排泄率。
在完成研究的161名儿童中，119名（73%）在入组时患有热带肠病（L:M > 0.10）。接受鼠李糖乳杆菌GG治疗的儿童在甘露醇（平均±标准差：分别为8.9±4.4和8.9±3.9）、乳果糖（分别为0.31±0.20和0.33±0.23）或蔗糖（分别为0.078±0.058和0.082±0.075）的排泄量（占给药剂量的百分比）方面与安慰剂组相比无显著差异。鼠李糖乳杆菌组和安慰剂组之间的L:M和S:L也无显著差异（L:M分别为0.19±0.13和0.20±0.12；S:L分别为0.58±0.46和0.65±0.57）。
给予鼠李糖乳杆菌GG 30天对3至5岁马拉维儿童的肠道完整性没有影响。
