Lazzerini Marzia
Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy.
Curr Opin Clin Nutr Metab Care. 2016 May;19(3):239-43. doi: 10.1097/MCO.0000000000000276.
The clinical management of acute diarrhea is based on the use of oral rehydration salts and appropriate nutrition. In addition, the WHO and The United Nations Children's Fund recommend zinc supplementation for diarrhea in children below 5 years. This article aims at reviewing recent literature on the effects of oral zinc for treating acute diarrhea in children.
Recent studies confirm that zinc supplementation has a benefit in children below 5 years with acute diarrhea in countries at medium or high risk of zinc deficiency. A few small trials have reported a benefit of zinc in children at low risk of zinc deficiency, with heterogeneity in results. No recent study has explored the effects of zinc in children younger than 6 months, and in this age group previous research refuted any benefit from zinc.
Current literature supports the use of oral zinc in treating diarrhea in children older than 6 months, especially if at risk of zinc deficiency, such as children with poor diets exposed to recurrent gastrointestinal infections. More research is needed to confirm findings in children at low risk of zinc deficiency. Currently there is no evidence that zinc benefits children younger than 6 months.
急性腹泻的临床管理基于口服补液盐的使用和适当的营养。此外,世界卫生组织和联合国儿童基金会建议对5岁以下儿童腹泻进行补锌治疗。本文旨在综述近期关于口服锌治疗儿童急性腹泻效果的文献。
近期研究证实,在锌缺乏风险中等或较高的国家,补锌对5岁以下患急性腹泻的儿童有益。一些小型试验报告了锌对锌缺乏风险较低儿童的益处,但结果存在异质性。最近没有研究探讨锌对6个月以下儿童的影响,而此前该年龄组的研究驳斥了锌有任何益处的观点。
当前文献支持对6个月以上儿童腹泻使用口服锌治疗,特别是存在锌缺乏风险的儿童,如饮食不良且反复发生胃肠道感染的儿童。需要更多研究来证实锌缺乏风险较低儿童的研究结果。目前没有证据表明锌对6个月以下儿童有益。