Ansaldi N, Dell'Olio D, Poli E, Grandi G
Istituto di Discipline Pediatriche, Sezione di Gastroenterologia dell'Università di Torino.
Minerva Pediatr. 1990 Jan-Feb;42(1-2):9-14.
Oral rehydration therapy has gained worldwide acceptance as the standard treatment for acute diarrhoeal diseases in infants and children. Besides the high sodium glucose-electrolyte solution based on the WHO/UNICEF recommendations, many diverse formulations of oral rehydration solutions (ORS) have withstood the trial of prolonged clinical use, their main differences concerning the concentration of sodium, the choice of the glycidic component, the use of bicarbonate as buffer or its substitution with acetate or citrate. It was recently hypothesized that glucose polymers-containing ORS markedly improve the intestinal sodium/glucose cotransport by delivering glucose at its critical site on the luminal villous membrane and therefore diminish stool output and duration of the diarrhoea. To investigate this hypothesis, the efficacies of two marketed ORS (table I), one containing sucrose and maltodextrin (solution A) and the other containing glucose (solution B) were compared. The study group comprised 13 infants and toddlers, 1 to 18 months old, who presented with acute diarrhea; 5 were males and 8 females; 7 were randomly allocated to receive solution A (Group A), 6 solution B (Group B). There were no significant differences between the groups in age, sex, causation of diarrhea or severity of dehydration before receiving ORS. Both groups showed a satisfactory response to 24 hours of treatment with either ORS, but a significantly lower stool output (number and global weight of stools) and higher blood glucose and bicarbonate levels were detected in group A (table II).(ABSTRACT TRUNCATED AT 250 WORDS)
口服补液疗法已作为婴幼儿急性腹泻疾病的标准治疗方法在全球范围内得到认可。除了基于世界卫生组织/联合国儿童基金会建议的高钠葡萄糖电解质溶液外,许多不同配方的口服补液溶液(ORS)都经受住了长期临床使用的考验,它们的主要区别在于钠的浓度、糖类成分的选择、使用碳酸氢盐作为缓冲剂或用醋酸盐或柠檬酸盐替代它。最近有假说认为,含葡萄糖聚合物的ORS通过在肠腔绒毛膜的关键部位输送葡萄糖,显著改善肠道钠/葡萄糖协同转运,从而减少粪便排出量和腹泻持续时间。为了验证这一假说,比较了两种市售ORS(表I)的疗效,一种含有蔗糖和麦芽糊精(溶液A),另一种含有葡萄糖(溶液B)。研究组包括13名1至18个月大的婴幼儿,他们患有急性腹泻;5名男性,8名女性;7名被随机分配接受溶液A(A组),6名接受溶液B(B组)。在接受ORS之前,两组在年龄、性别、腹泻病因或脱水严重程度方面没有显著差异。两组对24小时的任何一种ORS治疗均表现出满意的反应,但A组的粪便排出量(粪便数量和总重量)显著较低,血糖和碳酸氢盐水平较高(表II)。(摘要截短至250字)