Halverson J D, Teitelbaum S L, Haddad J G, Murphy W A
Ann Surg. 1979 Jun;189(6):785-90. doi: 10.1097/00000658-197906000-00016.
Jejunoileal bypass surgery is fraught with many longterm complications, among which is hypovitaminosis D. The relationship, if any, of hypovitaminosis D to the skeletal disease which may occur following this operation is, however, unknown. Consequently, we studied eight patients with low circulating levels of 25-hydroxyvitamin D who had undergone jejunoileal bypass at least two and one-half years previously. Despite the absence of skeletal symptoms, the bone biopsies of six of these patients were abnormal. The volume of trabecular bone was diminished in the group as a whole, and half the patients had an excess of unmineralized skeletal matrix. However, no noninvasive diagnostic technique identified those patients with skeletal disease. We therefore conclude that recognition of those jejunoileal bypass patients potentially at risk to develop clinically significant bone disease requires biopsy of the skeleton.
空肠回肠旁路手术充满了许多长期并发症，其中维生素D缺乏症就是其一。然而，维生素D缺乏症与该手术后可能发生的骨骼疾病之间（若存在关联的话）的关系尚不清楚。因此，我们研究了8例25-羟维生素D循环水平较低的患者，这些患者至少在两年半之前接受了空肠回肠旁路手术。尽管这些患者没有骨骼症状，但其中6例患者的骨活检结果异常。总体而言，该组患者的小梁骨体积减少，半数患者存在未矿化骨骼基质过多的情况。然而，没有任何非侵入性诊断技术能够识别出那些患有骨骼疾病的患者。因此，我们得出结论，要识别那些空肠回肠旁路手术后有潜在风险发展为具有临床意义的骨病的患者，需要进行骨骼活检。
