Langman J M, Rowland R
Institute of Medical and Veterinary Science, Adelaide, South Australia.
J Clin Pathol. 1990 Jul;43(7):537-40. doi: 10.1136/jcp.43.7.537.
Endoscopic duodenal biopsy specimens from 100 predominantly adult Caucasian patients under investigation for gastrointestinal symptoms were used to establish reference ranges for lactase, sucrase, and maltase in the duodenum. Duodenal and jejunal disaccharidase values were compared and the association between disaccharidase activity and morphology in the duodenum was examined. Mean lactase activities were about 40% lower in the duodenum compared with the jejunum; maltase was reduced to a lesser extent; and sucrase activities were much the same in the two sites. Lactase deficiency was found in 24 patients of whom 14 (58%) had duodenal disease. The presence of moderate to severe duodenal lesions was associated with a significant decrease in all disaccharidase activities, while only lactase was reduced in mild lesions. Twelve patients had normal lactase activity, despite the presence of duodenal disease. It is concluded that specific reference ranges for duodenal mucosal disaccharidase activity are required as this is less than that of jejunum. Reduced duodenal disaccharidase activity is usually but not invariably associated with morphological abnormality.
从100名主要为成年白种人且因胃肠道症状接受调查的患者身上获取十二指肠活检标本，用于确定十二指肠中乳糖酶、蔗糖酶和麦芽糖酶的参考范围。比较十二指肠和空肠的双糖酶值，并检查十二指肠中双糖酶活性与形态之间的关联。与空肠相比，十二指肠中的乳糖酶平均活性约低40%；麦芽糖酶降低程度较小；两个部位的蔗糖酶活性大致相同。在24名患者中发现乳糖酶缺乏，其中14名（58%）患有十二指肠疾病。中度至重度十二指肠病变的存在与所有双糖酶活性的显著降低有关，而轻度病变中只有乳糖酶降低。尽管存在十二指肠疾病，但有12名患者的乳糖酶活性正常。结论是，由于十二指肠黏膜双糖酶活性低于空肠，因此需要特定的十二指肠黏膜双糖酶活性参考范围。十二指肠双糖酶活性降低通常但并非总是与形态异常相关。
