Kelch L, Adlung J, Grazikowske H, Ritter U
Chirurg. 1976 May;47(5):280-3.
Of 40 patients with a partial gastrectomy (Billroth-II) 10 developed a milk intolerance and 11 had a lactase deficiency, the latter in 4 cases appearing together with a decrease in other disaccharidases. Only 2 of the 11 lactase-deficient patients complained of milk intolerance. The Ethanol lactose tolerance test (ELTT) was performed in 21 patients and was found to be abnormal in 6. Whereas cases of abnormal ELTT usually (4 of 6 cases) showed a lactase deficiency, only 2 patients with milk intolerance showed an abnormal ELTT and lactase deficiency. Milk intolerance can therefore only exceptionally be explained by lactase deficiency, and lack of lactase in the upper jejunum usually does not produce intolerance symptoms. Moreover, in comparable determinations from the afferent and efferent jejunal loop no differences in enzyme activities could be observed.
在40例行部分胃切除术(毕罗Ⅱ式)的患者中,10例出现牛奶不耐受,11例有乳糖酶缺乏,其中4例乳糖酶缺乏同时伴有其他双糖酶活性降低。11例乳糖酶缺乏患者中只有2例主诉有牛奶不耐受。对21例患者进行了乙醇乳糖耐量试验(ELTT),其中6例结果异常。虽然ELTT异常的病例通常(6例中的4例)存在乳糖酶缺乏,但只有2例牛奶不耐受患者ELTT异常且有乳糖酶缺乏。因此,牛奶不耐受仅在极少数情况下可由乳糖酶缺乏解释,空肠上段乳糖酶缺乏通常不会产生不耐受症状。此外,在对空肠输入袢和输出袢进行的类似检测中,未观察到酶活性有差异。