婴儿短期使用抗菌药物和继发性乳糖不耐受的相关性  

Correlation between short-term use of antibiotics and secondary lactose intolerance of infants

作　　者：叶环[1,2] 俞栋 徐琛 阮欢 YE Huan;YU Dong;XU Chen(Department of Pediatrics,Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China;Medical College of Hangzhou Normal University,Hangzhou,Zhejiang 310018,China)

机构地区：[1]杭州师范大学附属医院儿科,浙江杭州310015 [2]杭州师范大学医学院,浙江杭州310018 [3]绍兴市人民医院小儿内科,浙江绍兴312000

出　　处：《中国妇幼保健》2022年第20期3764-3767,共4页Maternal and Child Health Care of China

基　　金：浙江省大学生科技创新活动计划暨新苗人才计划项目(2018R413062)。

摘　　要：目的分析婴儿短期使用抗菌药物和继发性乳糖不耐受的相关性,为临床诊治提供参考依据。方法选取2017年1月—2018年11月杭州师范大学附属医院儿科收治的短期使用β-内酰胺类抗菌药物后出现腹泻的107例婴儿为观察组,同期在儿童保健门诊健康体检的无腹泻和近7 d无抗菌药物使用史的62例婴儿为对照组。留取观察组和对照组婴儿尿液,采用半乳糖氧化酶法检测尿液中半乳糖水平来间接判断乳糖酶的活性。将观察组中判定为乳糖酶缺乏的婴儿再随机分成两组,常规组予以常规综合治疗,乳糖酶组在常规综合治疗基础上服用乳糖酶治疗,根据疗效评判标准记录患儿腹泻治疗情况。结果观察组107例婴儿中,乳糖酶缺乏86例(80.37%);对照组62例婴儿中,乳糖酶缺乏35例(56.45%),观察组婴儿乳糖酶缺乏发生率显著高于对照组,差异有统计学意义(χ^(2)=11.047,P<0.05)。观察组分成口服组和静脉滴注组两组。口服组41例婴儿,乳糖酶缺乏34例(82.93%);静脉滴注组66例婴儿,乳糖酶缺乏52例(78.79%),两组婴儿乳糖酶缺乏发生率比较差异无统计学意义(χ^(2)=0.275,P>0.05)。观察组中乳糖酶缺乏婴儿共86例,其中常规组45例,乳糖酶组37例,失访4例。常规组治疗有效率(75.56%)与乳糖酶组(94.59%)比较,差异有统计学意义(χ^(2)=4.182,P<0.05)。观察组中乳糖酶缺乏婴儿86例,抗菌药物停用后2~4周后共随访37例,随访率为43.02%,其中仍乳糖酶缺乏婴儿19例,乳糖酶缺乏发生率为51.35%。结论短期使用抗菌药物后出现腹泻与继发性乳糖不耐受有关,建议临床合理使用抗菌药物,必要时尽早加用乳糖酶,以改善继发性腹泻。Objective To analyze the correlation between short-term use of antibiotics and secondary lactose intolerance of infants,provide a reference basis for clinical diagnosis and treatment.Methods From January 2017 to November 2018,107 infants with diarrhea after short-term use of antibiotics in Department of Pediatrics,Affiliated Hospital of Hangzhou Normal University were selected as observa⁃tion group,62 infants without diarrhea and use history of antibiotics within seven days in Child Health Clinic were selected as control group.The urinary samples of infants in observation group and control group were obtained,galactose oxidase method was used to detect urinary ga⁃lactose levels to indirectly predict the activity of lactase.The infants with lactase deficiency in observation group were randomly divided into two groups,the infants in routine group were given routine comprehensive treatment,and the infants in lactase group were given lactase treatment based on routine comprehensive treatment,the treatment situations of diarrhea were recorded according to the judgment criteria.Results Among 107 infants in observation group,86 infants(80.37%)were found with lactase deficiency;among 62 infants in control group,35 infants(56.45%)were found with lactase deficiency.The incidence rate of lactase deficiency in observation group was statisti⁃cally significantly higher than that in control group(χ2=11.047,P<0.05).The infants in observation group were divided into oral admin⁃istration group and intravenous drip group.Among 41 infants in oral administration group,34 infants(82.93%)were found with lactase de⁃ficiency;among 66 infants in intravenous drip group,52 infants(78.79%)were found with lactase deficiency.There was no statistically significant difference in the incidence rate of lactase deficiency between the two groups(χ2=0.275,P>0.05).In observation group,86 infants were found with lactase deficiency,then they were divided into routine group(45 cases)and lactase group(37 cases),4 infants were lost to follow up

关 键 词：婴儿 抗菌药物 继发性乳糖不耐受 乳糖酶 相关性 

分 类 号：R725.7[医药卫生—儿科]