von Lilienfeld-Toal H, Mackes K G, Kodrat G, Ochs H, Sonnenberg A
Am J Dig Dis. 1977 Jul;22(7):633-6. doi: 10.1007/BF01073083.
In an attempt to clarify the pathogenesis of the disturbed calcium metabolism which sometimes follows partial gastrectomy, we determined plasma 25-hydroxyvitamin D (25-OH-D) concentrations and urinary cyclic 3',5'-adenosine monophosphate (cAMP) excretion in patients who had previously undergone Billroth II gastrectomy and who were without clinical evidence of bone disease. In 17 Billroth II patients plasma 25-OH-D concentrations were reduced (12.6 +/- 4.6 ng/ml, mean +/- SD) compared to values in 17 control patients with diseases not affecting calcium metabolism (31.6 +/- 12.9 ng/ml, P less than 0.001). Urinary cAMP excretion, in part reflecting parathyroid function, was higher in 17 Billroth II patients (5.0 +/- 2.5 micronmol/day) than in the control patients (2.6 +/- 1.3 micronmol/day, P less than 0.001). These results suggest impaired nutrition of vitamin D and secondary hyperparathyroidism in Billroth II patients. While the cause of this phenomenon is unclear, it may contribute to the disturbance of calcium metabolism in patients who have had subtotal gastrectomy.
为了阐明部分胃切除术后有时会出现的钙代谢紊乱的发病机制，我们测定了曾接受毕罗Ⅱ式胃切除术且无骨病临床证据患者的血浆25-羟维生素D（25-OH-D）浓度和尿中环磷酸腺苷（cAMP）排泄量。17例毕罗Ⅱ式手术患者的血浆25-OH-D浓度（12.6±4.6纳克/毫升，均值±标准差）低于17例未影响钙代谢疾病的对照患者（31.6±12.9纳克/毫升，P<0.001）。部分反映甲状旁腺功能的尿cAMP排泄量，17例毕罗Ⅱ式手术患者（5.0±2.5微摩尔/天）高于对照患者（2.6±1.3微摩尔/天，P<0.001）。这些结果提示毕罗Ⅱ式手术患者存在维生素D营养障碍和继发性甲状旁腺功能亢进。虽然这种现象的原因尚不清楚，但它可能导致了接受胃大部切除术患者的钙代谢紊乱。
