Lifshitz F, Fagundes-Neto U, Ferreira V C, Cordano A, Ribeiro H da C
Department of Pediatrics, North Shore University Hospital, Cornell University Medical College, Manhasset, New York 11030.
J Am Coll Nutr. 1990 Jun;9(3):231-40. doi: 10.1080/07315724.1990.10720374.
The response to dietary treatment of patients with chronic post-infectious diarrhea and lactose intolerance was prospectively studied in 29 infants less than 1 year of age. All had gastroenteritis with diarrhea which persisted for more than 3 weeks. In the hospital, diarrhea continued and lactose intolerance was documented while being fed half-strength cow's milk formula. They were given dietary treatment with one of three formulas used for treatment of diarrhea in infancy. Improvement of diarrhea was more frequently achieved with Pregestimil when given as the initial therapy than with the other two formulas. With Pregestimil nine of 10 patients improved whereas only four of nine infants fed Portagen and one of 10 patients initially treated with soy formula improved. Pregestimil was also effective in three of five patients who initially failed to improve with Portagen and in four of eight patients tried with soy formula with or without carbohydrate. Additionally, in the patients who improved, recovery was more rapidly achieved with Pregestimil than with the other two formulas. Formula failures were due to intolerance to glucose polymers in three patients, possibly to protein in seven infants, and an intolerance to all nutrients in five patients. The improvement of the diarrhea was slower in patients who had evidence of colitis in rectal biopsies regardless of the dietary treatment given, but was not correlated with other variables, i.e., etiology of diarrhea, jejunal histology, or duration of diarrhea prior to treatment. However, as a group, the patients who failed to respond to Pregestimil were younger (less than 3 months of age), had more formula changes and associated infections, and were given more antibiotics; they also had more prolonged diarrhea before treatment and more severe jejunal mucosal lesions and jejunal bacterial overgrowth. The data suggests that Pregestimil seems to be the most effective formula for the treatment of infants with chronic post-infectious diarrhea and lactose intolerance.
对29名1岁以下婴儿进行了前瞻性研究，以观察慢性感染后腹泻和乳糖不耐受患者对饮食治疗的反应。所有婴儿均患肠胃炎且腹泻持续超过3周。在医院里，腹泻持续存在，且在喂半浓度牛奶配方奶时被证实存在乳糖不耐受。他们接受了三种用于婴儿腹泻治疗的配方奶之一的饮食治疗。与其他两种配方奶相比，最初使用Pregestimil进行治疗时，腹泻改善更为常见。使用Pregestimil时，10名患者中有9名病情改善，而喂食Portagen的9名婴儿中只有4名改善，最初使用大豆配方奶治疗的10名患者中只有1名改善。在最初使用Portagen治疗无效的5名患者中，有3名使用Pregestimil有效；在尝试使用含或不含碳水化合物的大豆配方奶的8名患者中，有4名有效。此外，在病情改善的患者中，使用Pregestimil比使用其他两种配方奶恢复得更快。配方奶治疗失败的原因是3名患者对葡萄糖聚合物不耐受，7名婴儿可能对蛋白质不耐受，5名患者对所有营养素均不耐受。无论给予何种饮食治疗，直肠活检有结肠炎证据的患者腹泻改善较慢，但与其他变量无关，即腹泻病因、空肠组织学或治疗前腹泻持续时间。然而，总体而言，对Pregestimil无反应的患者年龄较小（小于3个月），更换配方奶和合并感染更多，使用抗生素更多；他们在治疗前腹泻时间更长，空肠黏膜病变更严重，且空肠细菌过度生长。数据表明，Pregestimil似乎是治疗慢性感染后腹泻和乳糖不耐受婴儿最有效的配方奶。
