早期新生儿乳糖吸收不良与乳糖不耐受筛查及影响因素探讨

LACTOSE MALABSORPTION AND INTOLERANCE IN EARLY NEWBORN INFANTS

为了解乳糖吸收不良在新生儿早期的分布状况,本文采用醋酸铅半定量法测定了86例早期新生儿(足月儿74例、早产儿12例)的粪便乳糖及粪便pH值,结果提示:LM(乳糖吸收不良)在早期新生儿中发生率较高,达39.5％,而LI(乳糖不耐受)发生率为5.8％,说明大部分乳糖吸收不良的新生儿不伴有消化道症状。进一步分析,LM/LI的发生与分娩方式、围产期缺氧史、孕周、喂养史及性别均无关。本文随访了全部5例LI患儿,虽未经治疗,腹泻、腹胀症状多在2～3周内消失,最长1例症状持续至6周,生后3～4个月时复查粪便乳糖均转阴,同时生长发育良好。故新生儿早期的LM/LI系一个暂时性的缺乏,发育性的过程,考虑与肠粘膜发育不够成熟有关。

To investigate lactose malaborption(LM) in early newborn. Using half-quantitative analysis by acetate lead. The stool lactose and pH were measured in 86 newborn cases. The result showed that the incidence of LM was 39.5%, and the incidence of LI was 5.8%. There were no digestive system symptom in the most of LM. The happening of LM/LI had no relationship with style of parturition, hypoxic history of perinatal period, gestalional age, feeding history, and sex. Clinical symptom of the 5 LJ cases disappeared in 2 ~ 6 weeks later without treatment. So we guess LM/LI is a temporary process in newborn period . It may related to immaturity of intestinal mucous membrane.