小儿乳糖不耐受临床探讨

Clinical analysis of lactose intolerance in children

为探讨乳糖不耐受(LI)在兰州地区的发病情况,我们自1991.3～1993.8采用徐州医学院推荐的醋酸铅氢氧化铵法,观察腹泻患儿2958例,不伴有腹泻症状的肠道外感染患儿203例,并以40例健康婴儿粪便为对照。发现3岁以下腹泻患儿中乳糖不耐受的发生率占46.9％,且年龄越小发生率越高,各年龄组之间有显著差异(P<0.01);3岁以上患儿无1例LI,这与不再以乳食为主有关;轮状病毒性肠炎的LI发生率显著高于细菌性肠炎(P<0.005);不伴有腹泻症状的肠道外感染患儿的大便乳糖含量也明显高于正常对照组。醋酸铅氢氧化铵法系非创伤性检查,灵敏度高、特异性强、简便易行,尤其适于基层推广应用。

To investigate the incidence of lactose intolerance (LI) in children in the area of Lanzhou, The feces in 2958 cases with diarrhea, 203 parenteral infected cases without diarrhea and 40 normal cases were examined during March, 1991 to Aug. 1993 by the way of lead acetate with aqueous ammonia recommended by Xuzhou Medical College. The results showed that the incidence of LI reached to 46. 9% in the infants under three years old. The younger the infants were, the higher the incidence of LI would be. There was a significant difference between different age groups (p<0. 01). No LI case was found in the children over three years old, in whom the milk was a principal food, that would probably play an important role for the lower incidence of LI. It was noticed that there was a higher incidence of LI in the children with enteritis induced by wheel virus than that in the children with enteritis induced by bacterium (p<0. 005). The content of feces lactose in the parenteral infected cases without diarrhea was also higher than that in the normal cases. It is concluded that the way of lead acetate with aqueous ammonia is available for the diagnosis of LI as a non-invasive, sensitive, simple and easy way.