Wiecek Sabina, Wos Halina, Radziewicz Winnicki Igor, Komraus Marzena, Grzybowska Chlebowczyk Urszula
Department of Paediatrics, Medical University of Silesia, Katowice, Poland.
Turk J Gastroenterol. 2014 Apr;25(2):185-91. doi: 10.5152/tjg.2014.3994.
BACKGROUND/AIMS: The etiopathogenesis of inflammatory bowel disease (IBD) is multifactorial and not well explained. Environmental, genetic, and dietary factors play an important role. The aim of the study was the evaluation of lactase, saccharase, and maltase activity in patients with IBD.
The study comprised 65 children, aged 3-18 years. During a routine endoscopy, we took biopsies from the descending part of the duodenum. In these biopsies, we determined disaccharidase activity using Dahlquist's method.
Decreased lactase activity in the biopsies taken from the small intestine mucosa was most frequently observed in patients with Crohn's disease (5/15-33%) and least frequently seen in children with lymphocytic colitis (in 1/10-10%). The lowest mean values of lactase activity were found in the children with Crohn's disease and ulcerative colitis (1.7-2.5 U/1 g). Decreased saccharase activity in the biopsies obtained from the small intestine mucosa was most frequently observed in patients with lymphocytic colitis (in 5/10-50%) and ulcerative colitis (9/20-45%) and least frequently seen in children with non-specific undetermined colitis (in 7/20-35%). Decreased maltase activity in the small bowel mucosa was the most frequently observed in patients with Crohn's disease (in 5/15-33%) and least frequently seen in children with ulcerative colitis (in 3/20-15%). The lowest mean values of maltase activity were found in the children with Crohn's disease (5.4 U/1 g).
Therefore, it seems reasonable to perform diagnostic examinations aimed at lactose, saccharose, and maltose intolerance and to initiate a dietary regimen in children with IBD.
背景/目的：炎症性肠病（IBD）的发病机制是多因素的，目前尚未完全阐明。环境、遗传和饮食因素起着重要作用。本研究旨在评估IBD患者的乳糖酶、蔗糖酶和麦芽糖酶活性。
本研究纳入65名3至18岁的儿童。在常规内镜检查期间，我们从十二指肠降部取活检组织。在这些活检组织中，我们采用达尔奎斯特法测定双糖酶活性。
在小肠黏膜活检组织中，克罗恩病患者乳糖酶活性降低最为常见（5/15，占33%），而淋巴细胞性结肠炎患儿中最少见（1/10，占10%）。克罗恩病和溃疡性结肠炎患儿的乳糖酶活性均值最低（1.7 - 2.5 U/1 g）。在小肠黏膜活检组织中，蔗糖酶活性降低在淋巴细胞性结肠炎患者（5/10，占50%）和溃疡性结肠炎患者（9/20，占45%）中最为常见，在非特异性未定型结肠炎患儿中最少见（7/20，占35%）。小肠黏膜麦芽糖酶活性降低在克罗恩病患者中最为常见（5/15，占33%），在溃疡性结肠炎患儿中最少见（3/20，占15%）。麦芽糖酶活性均值最低的是克罗恩病患儿（5.4 U/1 g）。
因此，对IBD患儿进行针对乳糖、蔗糖和麦芽糖不耐受的诊断检查并启动饮食方案似乎是合理的。
