Department of Pediatrics, University of Texas Health Sciences Center at Houston-School of Medicine, Houston, TX 77030, USA.
J Pediatr. 2009 Dec;155(6):823-828.e1. doi: 10.1016/j.jpeds.2009.05.012. Epub 2009 Jul 22.
We explored whether gut inflammation, colonic fermentation, and/or an altered colonic flora could provide a pathophysiological mechanism for colic.
The study population consisted of 36 term infants ranging in age from 14 to 81 days. We measured fecal calprotectin (a marker of neutrophil infiltration) by ELISA; stool microorganisms by denaturing gradient gel electrophoresis, cloning, and sequencing; and breath hydrogen levels using gas chromatography.
During 24 hours, infants with colic (n = 19) cried and fussed for a mean of 314 +/- 36 (SEM) minutes, compared with control infants (n = 17, 103 +/- 17 minutes). Fecal calprotectin levels were 2-fold higher in infants with colic than in control infants (413 +/- 71 vs 197 +/- 46 microg/g, P = .042). Stools of infants with colic had fewer identifiable bands on denaturing gradient gel electrophoresis. Klebsiella species were detected in more colic patients than in control patients (8 vs 1, P = .02), whereas Enterobacter/Pantoea species were detected only in the control patients. These differences could not be attributed to differences in formula versus breast milk feeding, consumption of elemental formula, or exposure to antibiotics.
Infants with colic, a condition previously believed to be nonorganic in nature, have evidence of intestinal neutrophilic infiltration and a less diverse fecal microflora.
我们探讨肠道炎症、结肠发酵和/或结肠菌群改变是否可为肠绞痛提供病理生理学机制。
研究人群包括 36 名胎龄足月的婴儿，年龄 14～81 天。我们通过酶联免疫吸附试验（ELISA）检测粪便钙卫蛋白（中性粒细胞浸润的标志物）；用变性梯度凝胶电泳、克隆和测序检测粪便微生物；用气相色谱法检测呼气氢水平。
24 小时内，患有肠绞痛的婴儿（n=19）哭泣和烦躁的平均时间为 314±36（SEM）分钟，而对照组婴儿（n=17，103±17 分钟）。患有肠绞痛的婴儿粪便钙卫蛋白水平是对照组婴儿的 2 倍（413±71 比 197±46μg/g，P=0.042）。肠绞痛婴儿粪便的变性梯度凝胶电泳可识别的条带较少。患有肠绞痛的婴儿比对照组婴儿更容易检测到克雷伯菌（8 比 1，P=0.02），而肠杆菌/泛菌属仅在对照组婴儿中检测到。这些差异不能归因于配方奶与母乳喂养、使用无乳糖配方、或暴露于抗生素之间的差异。
先前被认为是非器质性的肠绞痛婴儿，存在肠道中性粒细胞浸润和粪便微生物多样性降低的证据。
