Greco L, D'Adamo G, Truscelli A, Parrilli G, Mayer M, Budillon G
Department of Paediatrics, University of Naples, Italy.
Arch Dis Child. 1991 Jul;66(7):870-2. doi: 10.1136/adc.66.7.870.
The changes of intestinal permeability before and after a gluten load were studied. The study group comprised 27 patients with coeliac disease (mean age 12.3 years) and 19 healthy controls matched by sex and age. Intestinal permeability was studied by measuring the urinary excretion of two sugars, lactulose and L-rhamnose, before and six hours after the ingestion of five palatable biscuits made with 50 g of gluten powder. The patients with coeliac disease had been on a gluten free diet during the previous two years. After the gluten load lactulose and L-rhamnose urinary excretion changed significantly in patients, and a significant increase in the lactulose: L-rhamnose ratio was also observed. No significant changes were observed in the controls. In view of the modification of the three biopsies diagnostic protocol made by the European Society for Paediatric Gastroenterology and Nutrition, permeability tests associated with single gluten challenges may be an added contribution to the accuracy of the diagnosis in childhood.
研究了麸质负荷前后肠道通透性的变化。研究组包括27例乳糜泻患者（平均年龄12.3岁）和19名按性别和年龄匹配的健康对照者。通过测量摄入5块用50克麸质粉制作的美味饼干之前和之后6小时两种糖（乳果糖和L-鼠李糖）的尿排泄量来研究肠道通透性。乳糜泻患者在过去两年一直采用无麸质饮食。麸质负荷后，患者的乳果糖和L-鼠李糖尿排泄量发生显著变化，同时乳果糖与L-鼠李糖的比率也显著增加。对照组未观察到显著变化。鉴于欧洲儿科胃肠病学和营养学会对三项活检诊断方案的修改，与单次麸质激发试验相关的通透性测试可能有助于提高儿童诊断的准确性。
