Mishkin B, Yalovsky M, Mishkin S
Royal Victoria Hospital, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Am J Gastroenterol. 1997 Jul;92(7):1148-53.
The aim of this study was to compare the prevalence of lactose malabsorption (LM) in various subgroups of inflammatory bowel disease patients with controls matched for age, sex, and ethnic origin.
In 260 patients with IBD [121 Crohn's disease (CD) and 139 ulcerative colitis (UC)] and 158 controls at low and moderate risk for LM the prevalence of lactose malabsorption was determined by H2 breath testing.
A control group at low ethnic risk had a prevalence of LM of 29.2% compared with 40.0% in CD (p < 0.025) and 13.3% of ulcerative colitis patients (p < 0.025). No significant differences were observed in comparable groups at moderate risk for LM. Irrespective of ethnic origin, 68.1% of patients with CD limited to the terminal ileum were lactose malabsorbers compared with 43.5% of patients with Crohn's colitis (p < 0.05). Additional analysis according to anatomical location indicated that Crohn's disease of the proximal small bowel (duodenum, jejunum), terminal ileum, terminal ileum plus colon, and colon alone were associated with a prevalence of LM of 100, 68.1, 54.5, and 43.5% respectively.
In patients at low ethnic risk there is a statistically significant increase in the prevalence of LM in CD patients and a decreased prevalence in ulcerative colitis compared with controls.
本研究旨在比较炎症性肠病患者各亚组中乳糖吸收不良（LM）的患病率与年龄、性别和种族相匹配的对照组。
对260例炎症性肠病患者[121例克罗恩病（CD）和139例溃疡性结肠炎（UC）]以及158例乳糖吸收不良低风险和中风险的对照组进行研究，通过氢气呼气试验测定乳糖吸收不良的患病率。
低种族风险的对照组乳糖吸收不良患病率为29.2%，而克罗恩病患者为40.0%（p<0.025），溃疡性结肠炎患者为13.3%（p<0.025）。在乳糖吸收不良中风险的可比组中未观察到显著差异。无论种族如何，局限于回肠末端的克罗恩病患者中有68.1%为乳糖吸收不良者，而克罗恩结肠炎患者为43.5%（p<0.05）。根据解剖位置的进一步分析表明，近端小肠（十二指肠、空肠）、回肠末端、回肠末端加结肠以及单独结肠的克罗恩病与乳糖吸收不良患病率分别为100%、68.1%、54.5%和43.5%。
在低种族风险患者中，与对照组相比，克罗恩病患者乳糖吸收不良的患病率有统计学显著增加，而溃疡性结肠炎患者患病率降低。
