影响轮状病毒肠炎致乳糖不耐受婴幼儿康复的因素

Influencing Factors of Recovery of Lactose Intolerance in Infants Caused by Rotaviral Enteritis

目的探讨影响轮状病毒(RV)肠炎所致乳糖不耐受(LI)婴幼儿康复的因素。方法 74例婴幼儿均以乳类为主食,确诊为RV肠炎并发LI后,辅以去乳糖奶粉喂养。一旦腹泻停止,均恢复母乳或配方乳(含乳糖)喂养,并行尿半乳糖试验。按恢复进食含乳糖饮食后是否重新出现腹泻、腹痛等LI症状以及尿半乳糖试验结果,将74例患儿分为2组:LI未康复组(31例)和LI已康复组(43例)。采用t检验、χ2检验和Logistic多元回归分析法分析影响RV肠炎所致婴幼儿LI康复的因素。结果 LI未康复组和LI已康复组患儿腹泻持续时间分别为(7.7±1.3)d和(6.9±0.9)d,二组比较差异有统计学意义(t=3.08,P<0.01);LI未康复组重型腹泻患儿19例,明显多于LI已康复组(15例)(χ2=5.06,P<0.05);LI未康复组患儿腹泻停止时肠道排毒阳性率(71%)明显高于LI已康复组(33%)(χ2=10.64,P<0.01)。在年龄、性别、体质量、喂养方式、肠道外表现等方面,二组比较差异均无统计学意义(Pa>0.05)。Logistic多元回归分析表明,腹泻停止时肠道排毒阳性是影响RV肠炎所致婴幼儿LI康复的主要危险因素(P<0.05)。结论腹泻停止时肠道排毒阳性是影响RV肠炎所致婴幼儿LI康复的主要危险因素。

Objective To study the related factors influencing recovery of lactose intolerance（LI）in infants caused by rotaviral enteritis.Methods A total of 74 infants fed with breast milk or cow＇s milk-based formulas were enrolled in this study.The infants diagnosed as LI due to rotaviral enteritis,were fed with lactose-free cow＇s milk-based formulas.As diarrhea stopped,breast milk or cow＇s milk-based formulas was fed and urinary galactose detection was used in every subject.All patients were divided into 2 groups（31 cases in LI incomplete recovery group,43 cases in LI recovery group）according to the clinical manifestations such as diarrhea,abdominal pain after taking lactose in food and the urinary galactose detection results.The related factors for recovery of LI in infants caused by rotaviral enteritis were analyzed by t test,χ2 test and multivariate Logistic regression.Results Duration of diarrhea in LI incomplete recovery group[（7.7±1.3）d] was significantly longer than that in LI recovery group [（6.9±0.9）d]（t=3.08,P0.01）.The number of serious diarrheic type in LI incomplete recovery group was significantly higher than that in LI recovery group（19 cases vs 15 cases;χ2=5.06,P0.05）.As diarrhea stopped,the po-sitive rate of rotavirus in stool was 71% in LI incomplete recovery group and 33% in LI recovery group,respectively.The difference of positive rate of rotavirus in stool between them was significant（χ2=10.64,P0.01）.There was no significant difference in age,gender,body weight,feeding type,extraintestinal manifestation between LI incomplete recovery group and LI recovery group（Pa0.05）.It indicated that rotavirus excretion in stool was the major risk factor for recovery of LI caused by rotaviral enteritis by multivariate Logistic regression analysis（P0.05）.Conclusion Rotavirus excretion in stool is the major risk factor of recovery of LI in infants caused by rotaviral enteritis.