Roediger W E, Lawson M J, Kwok V, Grant A K, Pannall P R
J Clin Pathol. 1984 Jun;37(6):704-7. doi: 10.1136/jcp.37.6.704.
No available test objectively measures impairment of function of the inflamed colonic mucosa in ulcerative colitis. To study function we assessed rectal bicarbonate output by rectal dialysis in the presence of water and bacterial fatty acid (n-butyrate) in 21 controls, 18 patients with acute ulcerative colitis, 12 patients with ulcerative colitis in remission, and 12 patients with other forms of colitis. In acute ulcerative colitis, compared with controls, bicarbonate output and pH was reduced (p less than 0.001); stimulated bicarbonate output with bacterial fatty acid (incremental bicarbonate output) was reduced by 80% in acute ulcerative colitis (p less than 0.01). Results indicate that bicarbonate output is a useful and selective test of mucosal function in acute ulcerative colitis. A diminished incremental bicarbonate output with n-butyrate supports the view of inadequate oxidation of bacterial fatty acids in vivo by the mucosa in ulcerative colitis. Whether the test will prove to be an index of prognosis or will aid choice between medical or surgical therapy requires further study.
目前尚无客观检测方法可衡量溃疡性结肠炎中炎症结肠黏膜的功能损害。为研究其功能，我们通过直肠透析，在水和细菌脂肪酸（正丁酸）存在的情况下，评估了21名对照者、18名急性溃疡性结肠炎患者、12名缓解期溃疡性结肠炎患者以及12名其他形式结肠炎患者的直肠碳酸氢盐分泌量。在急性溃疡性结肠炎患者中，与对照者相比，碳酸氢盐分泌量和pH值降低（p<0.001）；急性溃疡性结肠炎患者中，细菌脂肪酸刺激后的碳酸氢盐分泌量（增量碳酸氢盐分泌量）降低了80%（p<0.01）。结果表明，碳酸氢盐分泌量检测是急性溃疡性结肠炎黏膜功能的一种有用且具选择性的检测方法。正丁酸刺激后增量碳酸氢盐分泌量减少，支持了溃疡性结肠炎中黏膜对细菌脂肪酸体内氧化不足的观点。该检测是否会成为预后指标或有助于在药物治疗与手术治疗之间做出选择，尚需进一步研究。
