Hammer H F, Petritsch W, Pristautz H, Krejs G J
Medizinische Universitätsklinik, Graz.
Wien Klin Wochenschr. 1996;108(5):137-41.
The recognition of hydrogen nonexcretion in up to 20% of tested subjects and the large ethnic differences in the prevalence of lactose malabsorption make it necessary to reassess the diagnostic usefulness of the lactose tolerance test and the hydrogen breath test. Both tests were performed in 83 consecutive patients with suspected lactose malabsorption who ingested 50 g lactose. On a separate day a hydrogen breath test was performed after 25 g lactulose. The prevalence of hydrogen nonexcretion was 18%. The diagnostic usefulness of hydrogen breath test was influenced both by the individual threshold for hydrogen excretion and the amount of malabsorbed lactose. In addition to baseline values, breath samples for hydrogen measurements have to be taken at 30, 60, 90, 180, and 240 minutes after ingestion of lactose. For the lactose tolerance test only one measurement of serum glucose at 30 minutes is needed in addition to the baseline measurement. The combination of both tests excludes the influence of hydrogen nonexcretion, but even if a combined diagnostic approach utilizing the lactose hydrogen breath test and lactose tolerance test is used, 6% of patients presenting with symptoms suggestive of lactose intolerance cannot be classified.
在高达20%的受试对象中发现存在氢气不排泄现象，且乳糖吸收不良患病率存在较大种族差异，这使得有必要重新评估乳糖耐量试验和氢气呼气试验的诊断效用。对83例连续的疑似乳糖吸收不良患者进行了这两项试验，这些患者摄入了50克乳糖。在另一天，给予25克乳果糖后进行了氢气呼气试验。氢气不排泄的患病率为18%。氢气呼气试验的诊断效用受到氢气排泄个体阈值和乳糖吸收不良量的影响。除了基线值外，在摄入乳糖后30、60、90、180和240分钟必须采集用于测量氢气的呼气样本。对于乳糖耐量试验，除了基线测量外，仅需在30分钟时测量一次血清葡萄糖。这两项试验的联合使用排除了氢气不排泄的影响，但即使采用结合乳糖氢气呼气试验和乳糖耐量试验的联合诊断方法，仍有6%出现乳糖不耐受症状的患者无法分类。
