Duncombe V M, Bolin T D, Davis A E, Cummins A G, Crouch R L
Aust N Z J Med. 1978 Aug;8(4):392-6. doi: 10.1111/j.1445-5994.1978.tb04908.x.
There is controversy both in regard to the severity of small bowel mucosal damage attributable to giardiasis and to the causal relationship of these changes to the associated diarrhoea. In this series of 17 consecutive patients with giardiasis, small bowel histology and diarrhoea were independently assessed and compared. Disaccharidase assays were performed in 16 of these patients and a repeat biopsy obtained in seven cases. On histological examination the villous architecture varied from normal to sub-total villous atrophy. When these changes were compared with the severity of diarrhoea, a direct correlation was obtained, the more severe symptoms being associated with the more severe villous changes. Repeat biopsy after treatment demonstrated improvement in the histology which correlated with improvement in diarrhoea. Lactase activity was low in all patients with moderate or severe diarrhoea as well as in some patients with mild diarrhoea, two of whom had normal histology. This series demonstrates the occurrence of a spectrum of mucosal changes in giardiasis and supports the concept that these changes mediate the diarrhoea associated with this gut parasite.
关于贾第虫病所致小肠黏膜损伤的严重程度以及这些变化与相关腹泻的因果关系，均存在争议。在这一系列连续的17例贾第虫病患者中，对小肠组织学和腹泻情况进行了独立评估和比较。对其中16例患者进行了双糖酶检测，并对7例患者进行了重复活检。组织学检查显示，绒毛结构从正常到几乎完全绒毛萎缩不等。将这些变化与腹泻的严重程度进行比较时，发现存在直接相关性，症状越严重，绒毛变化越严重。治疗后的重复活检显示组织学有所改善，这与腹泻的改善相关。所有中度或重度腹泻患者以及一些轻度腹泻患者的乳糖酶活性均较低，其中两名轻度腹泻患者的组织学正常。本系列研究证明了贾第虫病存在一系列黏膜变化，并支持这样一种观点，即这些变化介导了与这种肠道寄生虫相关的腹泻。
