乳糜泻在中国慢性腹泻患儿中的发病情况  

Prevalence of celiac disease in children with chronic diarrhea in China

作　　者：王歆琼[1] 刘伟[1] 徐俊杰[2] 梅红[3] 彭罕鸣[3] 高原[3] 袁岚[4] 许春娣[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院儿内科,200025 [2]山东大学齐鲁儿童医院消化科 [3]武汉市儿童医院消化科 [4]成都市儿童医院消化科

出　　处：《中华儿科杂志》2010年第4期244-248,共5页Chinese Journal of Pediatrics

基　　金：益普生腹泻研究基金（IDF-2007-06）

摘　　要：目的研究乳糜泻在中国慢性腹泻患儿中的发病情况。方法收集2005年1月至2008年12月上海、济南、武汉、成都等地的慢性腹泻住院患儿进行临床多中心研究。详细记录所有患儿的病史、营养发育情况及相关辅助检查。数据处理采用SPSS11．5统计软件统计。结果共收集慢性腹泻患儿199例，纳入研究者118例，疑似乳糜泻的患儿14例（12％），其中1例确诊。去麸质饮食治疗有效。疑似病例男女比为12：2。年龄6个月～12岁。14例疑似患儿中6例伴随营养不良，4例伴有贫血。内镜诊断十二指肠黏膜绒毛萎缩4例，病理分期Ⅰ期1例，Ⅱ期2例，Ⅲa期7例，Ⅲb期3例，Ⅲc期1例。结论本研究第一次在中国慢性腹泻儿童中进行乳糜泻的筛查，研究发现疑似乳糜泻患儿14例，占慢性腹泻儿童的12％，确诊1例。乳糜泻确实在中国儿童中存在，应该引起中国儿科医师的重视。Objectives To investigate the prevalence of celiac disease in children with chronic diarrhea in China. Methods Inpatients of the pediatric hospitals in Shanghai, Jinan, Wuhan and Chengdu who were diagnosed as chronic diarrhea were recruited from Jan. 2005 to Dec. 2008. Their clinical history, physical examination and laboratory data were collected. The SPSS version 11.5 statistical package for Microsoft Windows was used for statistical analysis. Results Data of 199 patients and finally enrolled 118 hospitalized chronic diarrhea inpatients during the observation period were collected and 14 （ 12% ） of the chronic diarrhea patients were suspected as having celiac disease and in one the diagnosis of celiac disease was confirmed. Gluten-free diet （GFD） treatment was effective. M/F： 12/2, the age ranged from 6 months to 12 years; 43% （6/14） had malnutrition, 29% （4/14） had anemia, villous atrophy was found in 4 patients by endoscopy. Duodenal biopsies revealed stage Ⅰ in 1, stage Ⅱin 2, stage Ⅲ a in 7, stage Ⅲ b in 3 and stage Ⅲc in 1 patient according to the modified Marsh classification. Conclusion This study was the first time to report the research of celiac disease in children with chronic diarrhea in China. The percentage of suspicious celiac disease patients was 12% （14/118） in children and one was confirmed. CD exists in China. Chinese pediatricians should pay attention to the disease.

关 键 词：乳糜泻 腹泻 儿童 内窥镜检查 消化系统 

分 类 号：R725.7[医药卫生—儿科]