婴儿原发性乳糖不耐受症的临床诊断与治疗

目的 探讨婴儿原发性乳糖不耐受症的临床特征和诊治方法.方法 对我院消化科门诊2009年10月至201 1年2月诊断为原发性乳糖不耐受症婴儿的临床资料进行分析.结果 26例患儿均生后1～2个月内发病,病程1～4个月;母乳喂养10例,混合喂养8例,奶粉喂养8例.临床表现为慢性或迁延性腹泻,大便稀水样或泡沫状,每天4～8次;19例曾接受抗生素治疗无好转.经去乳糖饮食及口服益生菌均于1周症状好转,再次食用乳类临床症状复发.结论 婴儿原发性乳糖不耐受症主要表现为长期腹泻,易误诊并滥用抗生素,去乳糖饮食有助于确诊并治疗本病.

Diagnosis and treatment of primary lactase deficiency in infants

Objective To investigate the clinical characteristics and treatment strategies of primary lactase deficiency in infants.Methods The clinical data of 26 infants with primary lactase deficiency in Shenzhen Chidlren's hospital from October 2009 to February 2011 were analyzed retrospectively and the diagnoses were confirmed by dietary therapy.Results The patients were consisted of 19 males and 7 females,whose ages of onset ranged from 1 to 2 months,persisting 1 to 4 months.Breast feeding,mixed feeding and formula feeding were given in 10 cases,8 cases and 8 cases,respectively.The main clinical manifestations were persistent or chronic diarrhea,with watery and or foamy stools,4 to 8 times per day.Nineteen patients had received antibiotics but without improvement.Lactose free formula and oral probiotics improved the symptoms within 1 week in all 26 cases,but recurrence of symptoms followed reintroduction of dairy foods.Conclusion The clinical manifestations of primary lactase deficiency in infants are persistent or chronic diarrhea.Lactose free formula can be used to confirm the diagnosis and to improve the symptoms.