Alam A N, Sarker S A, Wahed M A, Khatun M, Rahaman M M
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Gut. 1994 Dec;35(12):1707-11. doi: 10.1136/gut.35.12.1707.
The effect of zinc supplementation on intestinal permeability changes and protein loss was studied in 32 children aged between 1 and 12 years during bouts of acute shigellosis and after recovery. An intestinal permeability test and then a 48 hour balance study were performed on all patients. They were then blindly assigned to receive vitamin B syrup either with or without zinc acetate (15 mg/kg per day) for a month. All patients received a five day course of nalidixic acid. The balance study was repeated during convalescence and follow up, but a permeability test was done only at follow up after one month. Intestinal permeability, expressed as a urinary lactulose:mannitol excretion ratio, improved significantly (p = 0.001) along with a significant increase (p = 0.005) in mannitol excretion in the zinc supplemented children, suggesting a resolution of small bowel mucosal damage. The latter was associated with a higher coefficient of nitrogen absorption (p = 0.03), suggesting a possible role of zinc in the treatment of shigellosis. Enteric protein loss, as assessed by faecal alpha 1 antitrypsin clearance, was not influenced by zinc supplementation.
在32名1至12岁的儿童急性志贺菌病发作期间及恢复后，研究了补锌对肠道通透性变化和蛋白质流失的影响。对所有患者进行了肠道通透性测试，然后进行了48小时的平衡研究。然后将他们随机分为两组，一组接受含维生素B糖浆和醋酸锌（每天15毫克/千克）的治疗，另一组只接受含维生素B糖浆的治疗，为期一个月。所有患者均接受了为期五天的萘啶酸治疗。在康复期和随访期间重复进行平衡研究，但仅在一个月后的随访时进行通透性测试。以尿乳果糖：甘露醇排泄率表示的肠道通透性在补锌儿童中显著改善（p = 0.001），同时甘露醇排泄显著增加（p = 0.005），提示小肠黏膜损伤得到缓解。后者与较高的氮吸收系数相关（p = 0.03），提示锌在志贺菌病治疗中可能发挥作用。通过粪便α1抗胰蛋白酶清除率评估的肠道蛋白质流失不受补锌影响。
