Prinsloo J G, Wittmann W, Kruger H, Freier E
Arch Dis Child. 1971 Aug;46(248):474-8. doi: 10.1136/adc.46.248.474.
Oral lactose and glucose/galactose loading tests were done in Bantu children convalescing from kwashiorkor and pellagra. Small bowel biopsies and disaccharidase estimations were performed in all except 2 patients. Lactose absorption was more impaired and intestinal lactase levels were lower in the pellagra than in the kwashiorkor group. The fact that diarrhoea after admission to hospital was less common in pellagra than kwashiorkor was ascribed to a lesser lactose load due to the early introduction of a mixed diet in the former group, in comparison with milk feeds only in the latter group. The absence of troublesome diarrhoea while on moderate quantities of lactose in the diet, in the presence of low intestinal lactase levels, but evidence of lactose malabsorption after loading, has a bearing on preventive and therapeutic nutrition programmes in non-Caucasian children. Lactase deficiency is not necessarily synonymous with symptomatic lactose intolerance if the threshold is not exceeded. Concern is expressed that excessive caution against the use of milk may lead to a worsening of infantile malnutrition in developing countries.
对正在从夸休可尔症和糙皮病中康复的班图儿童进行了口服乳糖和葡萄糖/半乳糖负荷试验。除2名患者外，对所有儿童均进行了小肠活检和双糖酶测定。与夸休可尔症组相比，糙皮病组的乳糖吸收受损更严重，肠道乳糖酶水平更低。糙皮病组入院后腹泻比夸休可尔症组少见，这一事实归因于前者较早引入混合饮食，与后者仅喂牛奶相比，乳糖负荷较低。在饮食中摄入适量乳糖时没有出现麻烦的腹泻，尽管肠道乳糖酶水平较低，但负荷后有乳糖吸收不良的证据，这与非白种儿童的预防和治疗营养方案有关。如果未超过阈值，乳糖酶缺乏不一定等同于有症状的乳糖不耐受。有人担心，对牛奶使用过度谨慎可能会导致发展中国家婴儿营养不良情况恶化。
