Pawłowska Katarzyna, Seredyński Rafał, Umławska Wioleta, Iwańczak Barbara
2 Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland.
Department of Physical Chemistry of Microorganisms, Institute of Genetics and Microbiology, University of Wroclaw, Wroclaw, Poland.
Arch Med Sci. 2018 Jan;14(1):88-93. doi: 10.5114/aoms.2016.57884. Epub 2016 Jul 20.
Lactose malabsorption arises from lactase deficiency and may lead to lactose intolerance - gastrointestinal symptoms after lactose ingestion. Occurrence and severity of the symptoms are influenced by many factors, including the dose of lactose and the intensity of its colonic fermentation to short chain fatty acids and gases.
The hydrogen breath test (HBT) after 30 g or 50 g of lactose was performed in 387 children. Further analysis included children who had a positive HBT result. The HBT parameters were net hydrogen concentration in each breath and total net hydrogen concentration during the HBT. The time of the first hydrogen rise was also calculated. HBT parameters were analyzed according to symptoms occurrence (lack or present), symptoms severity (lack, moderate or severe) and the dose of lactose (30 g or 50 g).
One hundred and six children (12.1 years, 46 boys) had a positive HBT result. Symptoms occurrence was positively related to net hydrogen concentration at 30 min, 60 min and 90 min ( < 0.001 at each time point), as well as to the total net hydrogen concentration ( < 0.001). There were no differences in hydrogen excretion between subjects with moderate and severe symptoms after lactose ingestion. Symptoms were more frequent in subjects given 50 g of lactose than in those given 30 g of lactose (79% vs. 47%, = 0.003). In both dose groups symptoms occurrence was related to hydrogen excretion.
Symptoms occurrence is closely related to hydrogen excretion and to the dose of ingested lactose.
乳糖吸收不良源于乳糖酶缺乏，可能导致乳糖不耐受——摄入乳糖后出现胃肠道症状。症状的发生和严重程度受多种因素影响，包括乳糖剂量及其结肠发酵为短链脂肪酸和气体的强度。
对387名儿童进行了30克或50克乳糖后的氢呼气试验（HBT）。进一步分析包括HBT结果呈阳性的儿童。HBT参数为每次呼气时的净氢浓度以及HBT期间的总净氢浓度。还计算了首次氢上升的时间。根据症状发生情况（有无）、症状严重程度（无、中度或重度）和乳糖剂量（30克或50克）对HBT参数进行分析。
106名儿童（12.1岁，46名男孩）HBT结果呈阳性。症状发生与30分钟、60分钟和90分钟时的净氢浓度呈正相关（每个时间点均<0.001），也与总净氢浓度呈正相关（<0.001）。摄入乳糖后中度和重度症状患者的氢排泄量无差异。给予50克乳糖的患者症状比给予30克乳糖的患者更频繁（79%对47%，P = 0.003）。在两个剂量组中，症状发生均与氢排泄有关。
症状发生与氢排泄及摄入乳糖的剂量密切相关。
