不同年龄段婴幼儿抗生素性腹泻与乳糖不耐受的相关性研究

Relationship between Antibiotic Associated Diarrhea and Lactose Intolerance

目的探讨不同年龄段婴幼儿应用β-内酰胺类抗生素后出现腹泻与乳糖不耐受的相关性。方法选择近3个月以乳糖乳制品为主食的住院应用β-内酰胺类抗生素的患儿80例，根据年龄分为4组，应用β-内酰胺类抗生素出现腹泻后，采用尿半乳糖测试盒进行测试，并记录乳糖不耐受的发生情况，同时对患儿进行便常规、便一般细菌培养、便轮状病毒检测，并记录其检测结果。结果80例样本中便常规示：红细胞：无或0-1个／HP；白细胞：无或0～1＋／HP；脂肪滴：（-）。便一般细菌培养均为阴性。便轮状病毒检测阴性77例（96．25％），阳性3例（4．75％）（其中2例乳糖不耐受阳性，1例乳糖不耐受阴性）。乳糖不耐受结果阳性44例（55．00％），阴性36例（45．00％）。不同年龄组乳糖不耐受阳性率比较，差异有统计学意义（x2=14．95，P〈0．001）。结论β-内酰胺类抗生素可破坏肠道乳糖酶活性致腹泻，即药物性腹泻继发乳糖不耐受。

Objective To discuss the relationship between the onset of diarrhea after application of beta lactam antibi- otics and lactose intolerance among infants of different ages. Methods Eighty infants fed on lactose for the latest 3 months and admitted for beta lactam antibiotics treatment were divided into four age groups. Urinary galactose assay kit was applied and lactose intolerance was recorded after diarrhea onset. At the same time, feces routine, feces routine bacterial culture, and rotaviruses detection were carried out. Results Results of feces routine of the 80 patients： red blood cells, none or 0 ~ 1/HP; white blood cells： none or 0 ~ 1/HP; fat droplets： （ - ） . No noticeable pathogenic bacteria were found during the feces routine bacterial culture. Results of rotavirus detection were negative in 77 cases （96. 25% ） and positive in 3 cases （4. 75% ） （of which 2 were with positive lactose intolerance results and 1 was with negative lactose intolerance results） . Lactose intolerance results were posi- tive in 44 cases （55.00%） and negative in 36 cases （45.00%） . Positive rates of lactose intolerance were significantly different among different age groups （ X2 = 14.95, P 〈 0. 001 ） . Conclusion Lactam antibiotics impair intestinal lactase activity and in- duce diarrhea, which means, drug -induced diarrhea is caused by secondary lactose intolerance.