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腹部放疗引起的肠道可逆性功能障碍

[Reversible functional disorders of the intestinal tract caused by abdominal radiotherapy].

作者信息

Ruppin H, Hotze A, Düring A, Reichert M, Bauer J, Stoll R, Herbst M, Mahlstedt J

出版信息

Z Gastroenterol. 1987 May;25(5):261-9.

PMID:3617840
Abstract

In 20 patients with malignancies receiving abdominal radiotherapy, tests for disturbed intestinal functions were performed at the beginning and at the end of the therapy and after 6 to 12 month following radiation. Four noninvasive tests were performed: 75Se-homotaurocholate (75SeHCAT) test for estimation of bile acid malabsorption; Schillings test for quantification of vitamin B12 absorption; H2-breath analysis before and after a test meal containing lactose as a parameter of lactose malabsorption; and 51Cr-EDTA test for estimation of intestinal permeability. Both bile acid and vitamin B12 absorption decreased significantly towards the end of abdominal radiotherapy in more than 50% of patients. Only one patient developed lactose malabsorption. After 6 to 12 month, these abnormalities had completely disappeared. In contrast, small intestinal permeability did not increase during radiotherapy but was significantly elevated 6 to 12 month following treatment as the only indication of chronic injury of small intestinal mucosa. During radiotherapy, a significant correlation existed between the severity of diarrhea and the degree of bile acid malabsorption.

摘要

对20例接受腹部放疗的恶性肿瘤患者,在治疗开始时、治疗结束时以及放疗后6至12个月进行肠道功能紊乱检测。进行了四项非侵入性检测:用75硒-同型牛磺胆酸盐(75SeHCAT)检测评估胆汁酸吸收不良;用希林试验定量维生素B12吸收;在含有乳糖的试验餐前后进行H2呼气分析,以此作为乳糖吸收不良的参数;用51铬-乙二胺四乙酸(51Cr-EDTA)检测评估肠道通透性。超过50%的患者在腹部放疗接近尾声时胆汁酸和维生素B12吸收均显著下降。仅1例患者出现乳糖吸收不良。6至12个月后,这些异常完全消失。相比之下,放疗期间小肠通透性未增加,但在治疗后6至12个月显著升高,这是小肠黏膜慢性损伤的唯一指征。放疗期间,腹泻严重程度与胆汁酸吸收不良程度之间存在显著相关性。

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