【recovering】《亚太临床营养杂志》丨A two-week-old infant, just recovering from acute

中国临床营养网(lcyycc)

Case study No.23

文本/亚太临床营养杂志(中文版)

资料来源：亚太临床营养杂志中文版订购号(APJCN-in-China)

A two-week-old infant、just recovering from acute gastro enteritis、has been refed with milk . the recovery was和however Retarded by watery

the fluid portion of the collected stool was examined by using a clinitest tablet(for reducing substances like glucose)。the results inding

this clinical situation could be explained as？

A.a recurrent gastro enteritis because of poor nutritional status .

B.Cow's milk allergy

C.Inherited enteropathy

D.genetic abnormality(probably lac tase-deficiency)

(Correct answer B)

案例研究25:牛奶过敏儿童病例报告

2周大的婴儿，急性胃肠炎刚刚恢复，恢复了牛奶喂养。

收集的粪便中的液体部分，用尿中还原物检查剂检验（像葡萄糖类的还原物质）。结果表明患者存在碳水化合物吸收障碍的问题。

这种临床表现可以解释为：

A． 由于营养状况不好导致胃肠炎再次发作

B． 牛奶过敏

C． 遗传性肠道疾病

D． 遗传异常（很可能是乳糖酶缺乏）

（正确答案是B）

The most clearly defined common cause of cow’s milk intolerance in infants is secondary disaccharidase deficiency occurring often following gastroenteritis or other bowel disorders. The condition is recognizable clinically and could be confirmed by detection of reducing substances in stools.

According to Rossi &Moser, congenital lactase deficiency is a rare condition, whereas temporary deficiency of lactase may be observed in premature and enterological conditions following infection, malabsorption, maldigestion, as well as after intestinal surgery and in immunological disorders.

As reported by Mastumura the incidence of late onset lactose intolerance, which is a lactase deficiency in the brush border of the intestinal cells, is much higher in Blacks and Orientals who have enjoyed milk for more than 2000 years. This corresponds well to the pattern of incidence of milk sensitivity.

婴儿牛奶不耐受的主要原因为继发性双糖酶缺乏，它通常发生在胃肠炎和其他肠道疾病之后。这种情况临床可以鉴别，通过粪便还原物质检测可以确认。

根据Rossi&Moser，先天性乳糖酶缺乏是很罕见的情况，然而暂时的乳糖酶缺乏通常发生在早产儿、感染、吸收不良、消化不良的胃肠疾病患者中，以及肠道手术后和免疫疾病。

根据Mastumura报道，迟发型乳糖不耐症主要是肠细胞刷状缘乳糖酶缺乏，发生率在2000多年前就喜欢喝牛奶的黑人与东方人中较高。这比较符合牛奶过敏症的发生模式。

附：

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