Sangaletti O, Petrillo M, Bianchi Porro G
Gastro-intestinal Unit, L. Sacco Hospital, Milan, Italy.
J Int Med Res. 1989 Nov-Dec;17(6):526-31. doi: 10.1177/030006058901700605.
Urinary oxalate concentrations were measured in 45 patients with quiescent Crohn's disease, four patients with chronic pancreatitis and five healthy subjects after a normal oxalate (150 g/day) diet, after a high-fat (150 g/day), normal oxalate diet and after and after a high-oxalate (500 mg/day) diet. Urinary oxalate concentrations were significantly (P less than 0.05) higher in patients with Crohn's disease and steatorrhoea, but not in those with chronic pancreatitis, after administrating a high-oxalate diet compared with healthy subjects. Mean oxalate values were 19.1 mg/24 h in controls compared with 65.8 mg/24 h in Crohn's disease patients. A direct correlation (r = 0.37, P less than 0.01) was established between faecal rats and urinary oxalate after oval oxalate load: this correlation (r = 0.43, P less than 0.01) is closer when only patients with Crohn's disease are considered. The study, therefore, confirmed a correlation between steatorrhoea and hyperoxaluria in patients with Crohn's disease; however, the high percentage of false positive results limits the use of urinary oxalate concentrations as a reliable indicator of lipid malabsorption. It is concluded that, at present, measurement of urinary oxalate cannot be recommended as a valid alternative to the Van de Kamer method for diagnosing lipid malabsorption.
对45例静止期克罗恩病患者、4例慢性胰腺炎患者和5名健康受试者，在给予正常草酸盐（150毫克/天）饮食后、高脂肪（150克/天）且正常草酸盐饮食后以及高草酸盐（500毫克/天）饮食后，测量其尿草酸盐浓度。与健康受试者相比，在给予高草酸盐饮食后，克罗恩病合并脂肪泻患者的尿草酸盐浓度显著升高（P<0.05），而慢性胰腺炎患者则无此现象。对照组草酸盐平均值为19.1毫克/24小时，而克罗恩病患者为65.8毫克/24小时。给予草酸盐负荷后，粪便比率与尿草酸盐之间建立了直接相关性（r = 0.37，P<0.01）：仅考虑克罗恩病患者时，这种相关性更强（r = 0.43，P<0.01）。因此，该研究证实了克罗恩病患者脂肪泻与高草酸尿症之间的相关性；然而，高比例的假阳性结果限制了尿草酸盐浓度作为脂质吸收不良可靠指标的应用。结论是，目前，不推荐将尿草酸盐测量作为诊断脂质吸收不良的范德卡默方法的有效替代方法。
