Pironi L, Callegari C, Cornia G L, Lami F, Miglioli M, Barbara L
Clinica Medica I; University of Bologna, Italy.
Am J Gastroenterol. 1988 Nov;83(11):1267-71.
In order to evaluate, in adult patients with Crohn's disease (CD), the prevalence of lactose malabsorption and intolerance, and the percentage who can tolerate a physiologic amount of milk in their diet, we tested 37 patients with CD (19 with intestinal resection, and 18 without) and 67 healthy controls (C) with the H2-breath test after they had ingested increasing loads of lactose as 10% solution (12.5 g, 25 g, and 50 g). Patients with malabsorption after the 12.5-g dose were tested further with 250 ml of milk. In the total group of patients and in the subgroup of those with resection, the prevalence of malabsorption was higher than in controls at all lactose loads; in patients who had not undergone resection, no significant difference was observed with the 12.5-g dose. Eleven of 18 patients who were malabsorbers with the 12.5-g dose had malabsorption also with 250 ml milk; however, only three of them (8% of the total group) experienced symptoms of intolerance. We conclude that, in adult patients with CD, 1) the prevalence of lactose malabsorption is increased, 2) in patients who have undergone intestinal resection, malabsorption occurs at a lower dose of the sugar than in patients who did not, and 3) since only 8% of patients experienced symptoms of intolerance after the ingestion of milk 250 ml, this amount can be empirically inserted in the daily diet of an adult with CD.
为了评估成年克罗恩病（CD）患者乳糖吸收不良和不耐受的患病率，以及饮食中能够耐受生理量牛奶的患者百分比，我们对37例CD患者（19例接受肠切除术，18例未接受）和67例健康对照者（C）进行了测试。让他们摄入递增剂量的10%乳糖溶液（12.5g、25g和50g）后，采用氢呼气试验检测。12.5g剂量后出现吸收不良的患者进一步给予250ml牛奶测试。在所有乳糖负荷下，患者总组以及接受切除术的亚组中，吸收不良的患病率均高于对照组；在未接受切除术的患者中，12.5g剂量时未观察到显著差异。18例在12.5g剂量时吸收不良的患者中，有11例饮用250ml牛奶时也存在吸收不良；然而，其中只有3例（占总组的8%）出现不耐受症状。我们得出结论，在成年CD患者中，1）乳糖吸收不良的患病率增加；2）接受肠切除术的患者，糖剂量较低时即出现吸收不良，而未接受手术的患者则不然；3）由于只有8%的患者在饮用250ml牛奶后出现不耐受症状，因此可以根据经验将此量纳入成年CD患者的日常饮食中。
