Caspary W F, Tönissen J
Klin Wochenschr. 1978 Jun 15;56(12):607-15. doi: 10.1007/BF01477009.
Oxalate-urolithiasis and hyperoxalaria have been reported to be a frequent complication in patients with small bowel disease, especially in patients with ileal resection due to Crohn's disease. Hyperabsorption of oxalate seems to be the main patholgenetic factor for "enteric" hyperoxalaria. Intestinal absorption and urinary excretion of oxalate was measured in patients with various gastrointestinal diseases after oral or rectal administration of 14C-oxalate. Kinetic data suggest that 14C-oxalate is absorbed in the small, the large bowel and the rectum as well. Oxalate absorption was decreased in patients with a colectomy and in active ulcerative colitis, but increased in patients with ileal resection, chronic liver disease, and steatorrhea due to chronic pancratitis or sprue. There existed a positive correlation between 14C-oxalate absorption and the amount of fecal fat excretion. The data suggest that hyperoxaluria and hyperabsorption of oxalate are not a specific finding in patients with bile acid malabsorption, but may occur too, in steatorrhea without alteration of bile acid metabolism.
据报道,草酸钙结石症和高草酸尿症是小肠疾病患者常见的并发症,尤其是因克罗恩病行回肠切除术的患者。草酸过度吸收似乎是“肠道”高草酸尿症的主要致病因素。对患有各种胃肠道疾病的患者口服或直肠给予14C-草酸后,测定其肠道对草酸的吸收及尿中草酸的排泄情况。动力学数据表明,14C-草酸在小肠、大肠和直肠均可被吸收。结肠切除术后患者及活动性溃疡性结肠炎患者的草酸吸收减少,但回肠切除术后患者、慢性肝病患者以及因慢性胰腺炎或口炎性腹泻导致脂肪泻的患者,草酸吸收增加。14C-草酸吸收与粪便脂肪排泄量之间存在正相关。数据表明,高草酸尿症和草酸过度吸收并非胆汁酸吸收不良患者所特有,在脂肪泻且胆汁酸代谢无改变的情况下也可能发生。