Baudon J J, Mougenot J F, Didry J R
Unité de Gastroenterologie Pédiatrique, Hôpital Trousseau, Paris, France.
J Pediatr Gastroenterol Nutr. 1987 Mar-Apr;6(2):244-51. doi: 10.1097/00005176-198703000-00015.
The lymphoblastic stimulation test (LST) with cow's milk proteins was performed in 114 infants. In 42 infants, digestive intolerance to cow's milk proteins (CMI) was suspected; withdrawal-rechallenge test confirmed intolerance in 34, and disproved it in the other eight patients. Of the other patients, 17 had acute gastroenteritis, 11 had postgastroenteritis subacute diarrhea, 12 had gluten intolerance, 14 had intractable diarrhea, and 18 had no digestive disorders. Of the 34 infants with CMI, 27 (79%) had a positive LST to one or more cow's milk proteins. Of the 34 positive LST patients, 12 also had soya intolerance; nine of these 12 infants (75%) had positive LST to soya. Of the eight infants who had a negative cow's milk rechallenge test, five (62%) had a positive LST. In the other groups, results were also positive in 12-27% of those having diarrhea of infectious origin or gluten intolerance, and in none of the infants without digestive disorders. Of the 14 cases of severe intractable diarrhea, 12 (86%) were also LST-positive, but CMI could not be excluded. LST was positive, particularly in diarrheas of neonatal origin. Lymphoblastic stimulation was induced more frequently by casein than by beta lactoglobulin, and least frequently by alpha lactalbumin. In conclusion, LST is frequently positive in CMI, but is not sufficiently specific to be a reliable diagnostic examination.
对114名婴儿进行了牛乳蛋白淋巴细胞刺激试验(LST)。42名婴儿疑似对牛乳蛋白(CMI)存在消化不耐受;撤药-再激发试验证实34名婴儿不耐受,另外8名患者不耐受不成立。在其他患者中,17名患有急性肠胃炎,11名患有肠胃炎后亚急性腹泻,12名患有麸质不耐受,14名患有顽固性腹泻,18名没有消化系统疾病。在34名患有CMI的婴儿中,27名(79%)对一种或多种牛乳蛋白的LST呈阳性。在34名LST阳性的患者中,12名也对大豆不耐受;这12名婴儿中有9名(75%)对大豆的LST呈阳性。在8名牛乳再激发试验阴性的婴儿中,5名(62%)LST呈阳性。在其他组中,感染性腹泻或麸质不耐受患者中12%-27%的结果也呈阳性,而无消化系统疾病的婴儿中无一呈阳性。在14例严重顽固性腹泻病例中,12例(86%)LST也呈阳性,但不能排除CMI。LST呈阳性,尤其是在新生儿期腹泻中。酪蛋白比β-乳球蛋白更频繁地诱导淋巴细胞刺激,而α-乳白蛋白诱导的频率最低。总之,LST在CMI中经常呈阳性,但特异性不足以成为可靠的诊断检查。