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锌与腹泻病:现状与未来展望

Zinc and diarrheal disease: current status and future perspectives.

作者信息

Scrimgeour Angus G, Lukaski Henry C

机构信息

US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, Massachusetts 01760, USA.

出版信息

Curr Opin Clin Nutr Metab Care. 2008 Nov;11(6):711-7. doi: 10.1097/MCO.0b013e3283109092.

Abstract

PURPOSE OF REVIEW

To evaluate clinical data indicating the benefits of oral zinc supplementation to prevent and/or treat diarrhea in children and extend these findings to adults.

RECENT FINDINGS

Zinc plays an important role in modulating host resistance to infectious agents and reducing the risk, severity, and duration of diarrheal diseases. Zinc is important in the developing world and in low-income and middle-income countries where mild-to-moderate zinc deficiency is highly prevalent.The WHO/UNICEF recommendations for zinc supplementation are based on meta-analyses of randomized, controlled intervention trials on children: 20 mg zinc/day for 10-14 days for children with acute diarrhea and 10 mg/day for infants under 6 months of age. Effective forms include sulfate, gluconate, or acetate. No similar studies have been conducted on adults. Thus, carefully conducted clinical trials are necessary to ascertain the efficacy of zinc in prevention of acute and persistent diarrhea in adults.

SUMMARY

Faced with rising antibiotic resistance and the lack of effective antidiarrheal vaccines, oral zinc provides substantial benefit in the reduction of stool output and disease duration combined with safety, selectivity of action, and low cost. Thus, oral zinc supplementation is a practical therapeutic intervention for the treatment of diarrhea in children, and by extension, should be provided to adults.

摘要

综述目的

评估临床数据,以表明口服补锌对预防和/或治疗儿童腹泻的益处,并将这些发现推广至成人。

最新发现

锌在调节宿主对感染原的抵抗力以及降低腹泻疾病的风险、严重程度和持续时间方面发挥着重要作用。在轻度至中度锌缺乏高度流行的发展中国家以及低收入和中等收入国家,锌尤为重要。世界卫生组织/联合国儿童基金会关于补锌的建议基于对儿童随机对照干预试验的荟萃分析:急性腹泻儿童每天补充20毫克锌,持续10 - 14天;6个月以下婴儿每天补充10毫克锌。有效形式包括硫酸盐、葡萄糖酸盐或醋酸盐。尚未对成人进行类似研究。因此,有必要进行精心设计的临床试验,以确定锌对预防成人急性和持续性腹泻的疗效。

总结

面对抗生素耐药性不断上升以及缺乏有效的抗腹泻疫苗的情况,口服锌在减少粪便排出量和疾病持续时间方面具有显著益处,且具有安全性、作用选择性和低成本的特点。因此,口服补锌是治疗儿童腹泻的一种切实可行的治疗干预措施,进而也应提供给成人。

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