Santavirta J, Mattila J, Kokki M, Pöyhönen L, Matikainen M
Department of Surgery, University Central Hospital, Tampere, Finland.
Ann Chir Gynaecol. 1990;79(3):134-8.
Absorption of bile acids was investigated using 75Se-homotaurocholate (SeHCAT) in 27 patients with ileoanal anastomosis and J-pouch, 7 patients with conventional ileostomy and 9 non-operated patients with ulcerative colitis. Retention of SeHCAT at seven days was higher in non-operated patients than in patients with ileoanal anastomosis (P less than 0.001) or conventional ileostomy (P less 0.01). There was no difference in retention of SeHCAT between patients with ileoanal anastomosis or conventional ileostomy. Malabsorption of bile acids was not associated with changes in blood chemistry or faecal fat excretion. Patients with ileoanal anastomosis and low retention of SeHCAT had more severe villous atrophy of the pouch mucosa than those with high retention (P less than 0.05). In conclusion, both patients with ileoanal anastomosis and conventional ileostomy have impaired absorption of bile acids when compared with non-operated patients with ulcerative colitis. In patients with ileoanal anastomosis, impairment of bile acid absorption is related to villous atrophy of the pouch mucosa.
采用75硒-高牛磺胆酸盐（SeHCAT）对27例回肠肛管吻合术和J形贮袋患者、7例传统回肠造口术患者以及9例未手术的溃疡性结肠炎患者的胆汁酸吸收情况进行了研究。未手术患者的SeHCAT在7天时的潴留率高于回肠肛管吻合术患者（P<0.001）或传统回肠造口术患者（P<0.01）。回肠肛管吻合术患者和传统回肠造口术患者之间的SeHCAT潴留率没有差异。胆汁酸吸收不良与血液化学变化或粪便脂肪排泄无关。SeHCAT潴留率低的回肠肛管吻合术患者的贮袋黏膜绒毛萎缩比潴留率高的患者更严重（P<0.05）。总之，与未手术的溃疡性结肠炎患者相比，回肠肛管吻合术患者和传统回肠造口术患者的胆汁酸吸收均受损。在回肠肛管吻合术患者中，胆汁酸吸收受损与贮袋黏膜绒毛萎缩有关。
