乳糖在肠道的代谢与乳糖不耐受症

李宇, 武庆斌

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (8) : 813-816.

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PDF(825 KB)
中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (8) : 813-816. DOI: 10.11852/zgetbjzz2025-0676
专家笔谈

乳糖在肠道的代谢与乳糖不耐受症

  • 李宇, 武庆斌
作者信息 +

Metabolism of lactose in the intestine and lactose intolerance in infants

  • LI Yu, WU Qingbin
Author information +
文章历史 +

摘要

乳糖代谢主要依赖于乳糖酶的水解作用,其活性受基因调控和发育阶段影响。乳糖不耐受症可分为原发性、继发性、先天性和发育性4类,临床表现多样。诊断方法包括氢呼气试验、乳糖耐量试验和基因检测等,但尚无简便可靠的方法学诊断标准。治疗策略涵盖饮食调整、酶替代疗法和益生菌应用等。本文总结了乳糖在肠道的代谢机制及乳糖不耐受症的病理生理、诊断和治疗进展,对深入了解乳糖代谢机制及改善乳糖不耐受症管理具有重要意义。

Abstract

The metabolism of lactose primarily relies on the hydrolytic action of lactase, whose activity is regulated by genetic factors and developmental stages.Lactose intolerance can be classified into four types: primary, secondary, congenital, and developmental, with diverse clinical manifestations.Diagnostic methods include hydrogen breath test, lactose tolerance test, and genetic testing, but there is currently no simple and reliable standardized diagnostic approach.Treatment strategies encompass dietary modifications, enzyme replacement therapy, and probiotic supplementation.This article summarizes the metabolic mechanisms of lactose in the intestine, as well as recent advances in the pathophysiology, diagnosis, and treatment of lactose intolerance.A deeper understanding of lactose metabolism is crucial for improving the management of lactose intolerance.

关键词

乳糖代谢 / 乳糖不耐受症 / 乳糖酶 / 肠道菌群

Key words

lactose metabolism / lactose intolerance / lactase / intestinal flora

引用本文

导出引用
李宇, 武庆斌. 乳糖在肠道的代谢与乳糖不耐受症[J]. 中国儿童保健杂志. 2025, 33(8): 813-816 https://doi.org/10.11852/zgetbjzz2025-0676
LI Yu, WU Qingbin. Metabolism of lactose in the intestine and lactose intolerance in infants[J]. Chinese Journal of Child Health Care. 2025, 33(8): 813-816 https://doi.org/10.11852/zgetbjzz2025-0676
中图分类号: R179   

参考文献

[1] Koepsell H.Glucose transporters in the small intestine in health and disease[J].Pflugers Arch, 2020, 472(9):1207-1248.
[2] Szilagyi A, Ishayek N.Lactose intolerance, dairy avoidance, and treatment options [J].Nutrients, 2018,10(12).
[3] Romero-Velarde E, Delgado-Franco D, García-Gutiérrez M, et al.The importance of lactose in the human diet: Outcomes of a Mexican consensus meeting[J].Nutrients, 2019, 11(11):2737.
[4] Coelho AI, Rubio-Gozalbo ME, Vicente JB, et al.Sweet and sour: An update on classic galactosemia[J].J Inherit Metab Dis, 2017,40(3):325-342.
[5] Deng Y, Misselwitz B, Dai N, et al.Lactose intolerance in adults: Biological mechanism and dietary management[J].Nutrients, 2015,7(9):8020-8035.
[6] Forsgård RA.Lactose digestion in humans: Intestinal lactase appears to be constitutive whereas the colonic microbiome is adaptable[J].Am J Clin Nutr, 2019, 110(2):273-279.
[7] Redel CA, Shulman RJ, Tivey DR.Determinants of lactose digestion in the miniature pig[J].Dig Dis Sci, 1997, 42, 137-144.
[8] Beumer J, Clevers H.Regulation and plasticity of intestinal stem cells during homeostasis and regeneration[J].Development, 2016, 143(20):3639-3649.
[9] Antonowicz I, Lebenthal E.Developmental pattern of small intestinal enterokinase and disaccharidase activities in the human fetus[J].Gastroenterology, 1977, 72(6):1299-1303.
[10] Counahan R, Walker-Smith J.Stool and urinary sugars in normal neonates[J].Arch Dis Child, 1976,51(7):517-20.
[11] Cederlund A, Kai-Larsen Y, Printz G, et al.Lactose in human breast milk an inducer of innate immunity with implications for a role in intestinal homeostasis[J].PLoS One, 2013, 8(1):e53876.
[12] 张梦媚.继发性乳糖不耐受婴儿的肠道菌群及乳糖酵解代谢研究[D].苏州:苏州大学,2022.
[13] Misselwitz B, Butter M, Verbeke K, et al.Update on lactose malabsorption and intolerance: Pathogenesis, diagnosis and clinical management[J].Gut, 2019, 68(11):2080-2091.
[14] He T, Venema K, Priebe MG, et al.The role of colonic metabolism in lactose intolerance[J].Eur J Clin Invest, 2008, 38(8):541-547.
[15] Porzi M, Burton-Pimentel KJ, Walther B, et al.Development of personalized nutrition: Applications in lactose intolerance diagnosis and management[J].Nutrients,2021,13(5):1503.
[16] Martínez Vázquez SE, Nogueira de Rojas JR, Remes Troche JM, et al.The importance of lactose intolerance in individuals with gastrointestinal symptoms[J].2020,85(3):321-331.
[17] Xue H, Zhang M, Ma J, et al.Lactose-induced chronic diarrhea results from abnormal luminal microbial fermentation and disorder of ion transport in the colon[J].Front Physiol, 2020,11:877.
[18] Malik TF, Panuganti KK.Lactose intolerance[M]//Treasure Island (FL).Stat Pearls Publishing, 2023.
[19] 李东丹,闫洁,杨艳玲.乳糖不耐受及饮食营养管理[J].中国实用儿科杂志, 2022, 37(10): 758-763.
Li DD, Yan J, Yang YL. Lactose intolerance and dietary nutrition management[J]. Chin J Prac Pediatr, 2022, 37(10): 758-763.(in Chinese)
[20] Shaukat A, Levitt MD, Taylor BC,et al.Systematic review: Effective management strategies for lactose intolerance[J].Ann Intern Med,2010, 152, 797-803.
[21] Ibba I,Gilli A,Boi MF, et al.Effects of exogenous lactase administration on hydrogen breath excretion and intestinal symptoms in patients presenting lactose malabsorption and intolerance[J].Biomed Res Int, 2014 (2014).
[22] De Oliveira LS, Wendt GW, Crestani APJ, et al.The use of probiotics and prebiotics can enable the ingestion of dairy products by lactose intolerant individuals[J].Clin Nutr, 2022, 41: 2644-2650.
[23] Ahn SI, Kim MS, Park DG, et al.Effects of probiotics administration on lactose intolerance in adulthood: A meta-analysis[J].J Dairy Sci, 2023, 106: 4489-4501.

基金

迪辅乐生物(上海)有限公司项目(MIHC/2019/04/Dipro)

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