Guedon C, Schmitz J, Lerebours E, Metayer J, Audran E, Hemet J, Colin R
Gastroenterology. 1986 Feb;90(2):373-8. doi: 10.1016/0016-5085(86)90935-2.
Animal experimentation with total parenteral nutrition (TPN) has revealed the occurrence of atrophy of the intestinal mucosa and decreased enzyme activities of the brush border, notably the disaccharidases. These findings have heretofore not been confirmed in human investigation. We performed endoscopic biopsies in the third part of the duodenum in 7 adults before TPN, after 21 days of TPN, and after a progressive oral refeeding. We noted a clear-cut decrease of major enzyme activities during TPN (sucrase, maltase, lactase, glucoamylase, acid aminopeptidase, dipeptidyl peptidase) without any morphologic modifications as observed with standard histology. Electron microscopy showed a slight but significant decrease in the height of microvilli. The decreased enzyme activities were rapidly restored after oral refeeding. Thus, the functional consequences of the modifications observed during medium-term TPN in adults are probably limited.
对动物进行全胃肠外营养（TPN）实验已揭示出肠黏膜萎缩以及刷状缘酶活性降低的情况，尤其是双糖酶。迄今为止，这些发现尚未在人体研究中得到证实。我们对7名成年人在接受TPN之前、TPN 21天后以及逐步经口重新喂养后，在十二指肠第三部分进行了内镜活检。我们注意到在TPN期间主要酶活性明显下降（蔗糖酶、麦芽糖酶、乳糖酶、葡糖淀粉酶、酸性氨肽酶、二肽基肽酶），而标准组织学观察未发现任何形态学改变。电子显微镜显示微绒毛高度略有但显著下降。经口重新喂养后，酶活性下降迅速恢复。因此，在成年人中期TPN期间观察到的这些改变所产生的功能后果可能是有限的。
