Zaporozhye State Medical University, Ukraine.
Georgian Med News. 2021 Feb(311):120-125.
The aim of the work - to determine the pathogenetic role of carbohydrate malabsorption syndrome in severity and duration of rotavirus infection symptoms in early aged children. The study included 60 breastfed children aged 1-24 months with rotavirus infection. The severity and duration of the main symptoms of rotavirus gastroenteritis were analyzed depending on the dynamic changes in laboratory parameters of carbohydrate malabsorption syndrome: the total amount of reducing carbohydrates in feces, lactose and glucose in feces, which were determined on II-III, V, VII and X days of the disease. To determine the total amount of reducing sugars in the coprofiltrates, the Benedict's test was used, the lactose in the feces was determined using the Malfatti's test, and the glucose was determined by the Glucophane test systems (Erba Lachema). It was found that the syndrome of carbohydrate malabsorption had the maximum pathogenetic effect on the severity of rotavirus diarrhea after the fifth day of the disease mainly due to lactase deficiency. Starting from the seventh day of rotavirus infection, with an increase in the level of carbohydrates in the feces by 0,5%, the frequency of liquid stools increases by 1 time per day. The prognostic sign of long-term diarrheal syndrome (≥9 days) is the total level of reducing sugars in the feces ≥1% on the fifth day of illness. If the result of the Benedict's test increases by 0,4% in this term, the duration of diarrhea increases by 1 day. When the level of carbohydrates in the stool ≥ 0,75% on the tenth day of the disease the risk of residual effects on discharge from the hospital (such as unstable stools 2-3 times a day, meteorism and flatulence) increases.
本研究旨在确定碳水化合物吸收不良综合征在婴幼儿轮状病毒感染症状的严重程度和持续时间中的发病机制作用。研究纳入了 60 名 1-24 月龄的母乳喂养的轮状病毒感染患儿。根据碳水化合物吸收不良综合征的实验室参数动态变化,分析了轮状病毒胃肠炎主要症状的严重程度和持续时间:粪便中总还原糖量、粪便中乳糖和葡萄糖量,这些参数在疾病的第 II-III、V、VII 和 X 天进行检测。采用 Benedict 试验检测粪便中总还原糖量,采用 Malfatti 试验检测粪便中乳糖,采用 Glucophane 试验系统(Erba Lachema)检测葡萄糖。结果发现,碳水化合物吸收不良综合征在疾病第 5 天以后对轮状病毒腹泻的严重程度具有最大的发病机制作用,主要与乳糖酶缺乏有关。从轮状病毒感染的第 7 天开始,粪便中碳水化合物含量每增加 0.5%,每日腹泻次数增加 1 次。长期腹泻综合征(≥9 天)的预后指标是疾病第 5 天粪便中总还原糖水平≥1%。如果在此期间 Benedict 试验的结果增加 0.4%,则腹泻持续时间增加 1 天。当粪便中碳水化合物水平在第 10 天达到≥0.75%时,出院后(如每日 2-3 次不稳定的粪便、腹胀和胃肠气胀)残留影响的风险增加。