Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
J Clin Biochem Nutr. 2013 Jul;53(1):55-9. doi: 10.3164/jcbn.12-116. Epub 2013 Apr 9.
Permeation of the small intestinal mucosa is a key mechanism in the induction of enteropathy. We investigated the effect of rebamipide in healthy subjects with diclofenac-induced small intestinal damage and permeability. In this crossover study, each treatment period was 1 week with a 4-week washout period. Diclofenac (75 mg/day) and omeprazole (20 mg/day) plus rebamipide (300 mg/day) or placebo were administered. Capsule endoscopy and a sugar permeability test were performed on days 1 and 7 in each period. Ten healthy subjects were enrolled. Small intestinal injuries were observed on day 7 in 6 of 10 subjects in both groups. Urinary excretion of administered lactulose increased from 0.30% to 0.50% of the initial dose during the first treatment period in the placebo group, and from 0.13% to 0.33% in the rebamipide group. Despite recovery from small-intestinal mucosal damage, the increased permeability in both groups resulted in sustained high levels of lactulose (0.50% to 1.06% in the placebo group and 0.33% to 1.12% in the rebamipide group) through the 4-week washout period. Diclofenac administration induced enteropathy and hyperpermeability of the small intestine. The sustained hyperpermeability during the washout period may indicate the presence of invisible fragility.
小肠黏膜的渗透是引起肠病的关键机制。我们研究了在健康受试者中使用瑞巴派特对双氯芬酸引起的小肠损伤和通透性的影响。在这项交叉研究中，每个治疗期为 1 周，洗脱期为 4 周。给予双氯芬酸（75mg/天）和奥美拉唑（20mg/天）加瑞巴派特（300mg/天）或安慰剂。在每个时期的第 1 天和第 7 天进行胶囊内镜检查和糖通透性试验。共纳入 10 名健康受试者。在两组中，10 名受试者中有 6 名在第 7 天观察到小肠损伤。在安慰剂组中，第 1 个治疗期内，给予的乳果糖排泄量从初始剂量的 0.30%增加到 0.50%，在瑞巴派特组中从 0.13%增加到 0.33%。尽管小肠黏膜损伤得到恢复，但两组的通透性增加导致乳果糖持续处于高水平（安慰剂组从 0.50%增加到 1.06%，瑞巴派特组从 0.33%增加到 1.12%），持续 4 周洗脱期。双氯芬酸给药诱导肠病和小肠高通透性。在洗脱期内持续的高通透性可能表明存在看不见的脆弱性。
