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[非感染性腹泻新生儿的乳糖不耐受]

[Lactose intolerance in neonates with non-infectious diarrhea].

作者信息

Su Hui-Min, Jiang Yi, Hu Yu-Lian, Yang Hui, Dong Tian-Jin

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2016 Apr;18(4):306-10. doi: 10.7499/j.issn.1008-8830.2016.04.005.

Abstract

OBJECTIVE

To investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal pH value and urine galactose determination for neonatal lactase deficiency.

METHODS

Seventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal pH value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group (45 neonates) and lactose tolerance group (24 neonates), and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge.

RESULTS

Fecal pH value and positive rate of urine galactose (65% vs 54%) showed no significant differences between the diarrhea and non-diarrhea groups (P>0.05). Fecal pH value showed no significant difference between the lactose intolerance and lactose tolerance groups (P>0.05), while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group (P<0.05).

CONCLUSIONS

The incidence of lactase deficiency is high in neonates, and diarrhea due to lactose intolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

摘要

目的

探讨非感染性腹泻新生儿乳糖不耐受的发生情况及其与腹泻的关系,评估粪便pH值及尿半乳糖测定对新生儿乳糖酶缺乏的诊断价值。

方法

选取2012年10月至2015年6月期间住院的70例发生非感染性腹泻的新生儿作为腹泻组,162例未发生非感染性腹泻的住院新生儿作为非腹泻组。采用试纸法测定粪便pH值。采用半乳糖氧化酶法检测尿半乳糖。半乳糖氧化酶阳性者诊断为乳糖酶缺乏,乳糖酶缺乏且伴有腹泻者诊断为乳糖不耐受。根据尿半乳糖检测结果,将腹泻组中进行尿半乳糖检测的69例新生儿分为乳糖不耐受组(45例)和乳糖耐受组(24例),比较两组治疗后的情况。对腹泻新生儿出院后3个月进行随访。

结果

腹泻组与非腹泻组粪便pH值及尿半乳糖阳性率(65%对54%)比较,差异无统计学意义(P>0.05)。乳糖不耐受组与乳糖耐受组粪便pH值比较,差异无统计学意义(P>0.05),而乳糖不耐受组新生儿排便恢复时间明显长于乳糖耐受组(P<0.05)。

结论

新生儿乳糖酶缺乏发生率高,易发生乳糖不耐受性腹泻。粪便pH值测定对腹泻新生儿乳糖不耐受的诊断无意义。

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