摘要目的 分析新生儿乳糖酶缺乏发生率及影响肠道乳糖酶分泌的相关因素.方法 前瞻性选取2016年2～12月杭州师范大学附属医院新生儿病房收治的新生儿为研究对象,留取喂奶后1～2h内的尿液进行尿半乳糖定性检测,并记录临床相关资料.根据尿检结果分为乳糖酶缺乏组和非乳糖酶缺乏组,比较两组新生儿基本情况,分析发生乳糖酶缺乏的相关因素.结果 研究期间共收治新生儿1 022例,根据入选标准最终纳入213例.尿半乳糖定性检测阳性154例,乳糖酶缺乏发生率为72.3％;其中42例伴随乳糖不耐受症状,占27.3％ (42/154).乳糖酶缺乏组阳性家族史比例、检测日龄均大于非乳糖酶缺乏组[23.4％比10.2％,(10.3±6.4)d比(8.1±5.8)d],胎龄小于非乳糖酶缺乏组[(37.8±2.9)周比(39.0±1.7)周),差异有统计学意义(P＜0.05).两组新生儿性别、出生体重、奶量及使用抗生素情况差异无统计学意义(P＞0.05).多因素Logistic回归分析显示,检测日龄(OR=1.065,95％ CI1.007～1.127)、阳性家族史(OR=2.912,95％CI1.053～8.056)是新生儿乳糖酶缺乏的独立危险因素;胎龄(OR=0.747,95％ CI0.617～0.904)是发生新生儿乳糖酶缺乏的独立保护因素.结论 新生儿乳糖酶缺乏发生率高,但仅部分患儿出现乳糖不耐受症状.阳性家族史、检测日龄是新生儿乳糖酶缺乏的独立危险因素,胎龄是新生儿乳糖酶缺乏的独立保护因素.

abstractsObjective To study the incidence of lactase deficiency and the risk factors affecting intestinal lactase secretion in newborns with lactase deficiency.Method From February to December 2016,newborns admitted to the neonatal ward of the Affiliated Hospital of Hangzhou Normal University were enrolled in this prospective study.Urine samples were taken within one to two hours after feeding for galactose qualitative tests,and the related clinical data were recorded.The newborns were assigned into lactase deficient group and non-lactase deficient group according to the test results.Then the risk factors of lactase deficiency were analyzed comparing the clinical data between the two groups.Result A total of 1 022 newborns were hospitalized during the research period,of whom 213 were enrolled in this study according to the inclusion criteria.154 cases had positive results in the urine galactose qualitative tests,yielding the incidence of lactase deficiency of 72.3 ％.42 cases had lactose intolerance symptoms,and the incidence of lactose intolerance was 27.3 ％ (42/154).Age and positive family history in lactase deficient group were higher than non-lactase deficient group (10.3 ±6.4 d vs.8.1 ±5.8 d and 23.4％ vs.10.2％),while the gestational age of lactase deficient group was lower than non-lactase deficient group (37.8 ±2.9 weeks vs.39.0 ± 1.7 weeks),and the differences between the two groups were statistically significant (P ＜ 0.05).No significant differences existed in gender,birth weight,antibiotics use and feeding volumes between the two groups (P ＞ 0.05).Multivariate Logistic regression analysis showed that age (OR =1.065,95％CI 1.007 ～ 1.127) and positive family history (OR =2.912,95％ CI 1.053 ～ 8.056) were the risk factors of lactase deficiency.Gestational age (OR =0.747,95％ CI 0.617 ～ 0.904) was the protective factor of lactase deficiency in newborns.Conclusion The incidence of lactase deficiency in newborns is high,but not all the newborns manifest lactose intolerance symptoms.Age and positive family history were the risk factors while gestational age was the protective factor for lactase deficiency in newborns.