新生儿非感染性腹泻乳糖不耐受发生情况调查

Lactose intolerance in neonates with non-infectious diarrhea

目的观察新生儿非感染性腹泻时乳糖不耐受的发生状况及其与腹泻的关系;评价大便p H值、尿半乳糖测定对新生儿乳糖酶缺乏的诊断意义。方法选取2012年10月至2015年6月70例发生非感染性腹泻的住院新生儿为腹泻组,同期选取162例无腹泻的住院新生儿为无腹泻组。采用试纸法测定两组大便p H值;半乳糖氧化酶法检测尿半乳糖,以尿半乳糖阳性诊断为乳糖酶缺乏,有乳糖酶缺乏的腹泻诊断为乳糖不耐受。根据尿半乳糖检测结果,将69例行尿半乳糖测定的腹泻组患儿分为乳糖不耐受组(n=45)和乳糖耐受组(n=24),比较两组新生儿治疗后的情况。腹泻患儿出院后3个月进行随访。结果腹泻组与非腹泻组新生儿大便p H值及尿半乳糖阳性率(65%vs 54%)比较差异均无统计学意义(P>0.05)。乳糖不耐受和耐受组腹泻患儿大便p H值比较差异无统计学意义(P>0.05),乳糖不耐受患儿大便恢复时间比耐受组患儿长(P<0.05)。结论新生儿乳糖酶缺乏发生率高,易发生乳糖不耐受性腹泻。大便p H值测定对判断腹泻患儿乳糖不耐受意义不大。

Objective To investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal p H value and urine galactose determination for neonatal lactase deficiency. Methods Seventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal p H value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group（45 neonates） and lactose tolerance group（24 neonates）, and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge. Results Fecal p H value and positive rate of urine galactose（65% vs 54%） showed no significant differences between the diarrhea and non-diarrhea groups（P〉0.05）. Fecal p H value showed no significant difference between the lactose intolerance and lactose tolerance groups（P〉0.05）, while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group（P〈0.05）. Conclusions The incidence of lactase deficiency is high in neonates, and diarrhea due to lactose intolerance tends to occur. Determination of fecal p H value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.