Miller L J, Owyang C, Malagelada J R, Gorman C A, Go V L
Gut. 1980 Aug;21(8):695-700. doi: 10.1136/gut.21.8.695.
Upper gastrointestinal function in response to a mixed nutrient meal was evaluated in hyperthyroid patients, both before and after therapy, and in healthy controls. Gastric secretion, gastric emptying, and pancreatic secretion were all normal and normally integrated postprandially in the hyperthyroid patients. Bile acid output was reduced (P less than 0.05) in this group of patients relative to healthy controls. Duodenal bile acid concentrations, however, were above the critical micellar concentration in most of the hyperthyroid patients, and the bile acid output and concentration remained unchanged in all patients three months after treatment. After radioactive iodine therapy, when gastrointestinal symptoms were returning toward normal, a small but statistically significant increase in gastric secretion was observed. However, gastric emptying and pancreatic secretion, like biliary secretion, remained unchanged. Abnormalities responsible for the diarrhoea and steatorrhoea in hyperthyroidism appear to reside primarily distal to the duodenum. However, reduced bile acid output may be a contributory factor in some patients.
对甲状腺功能亢进患者在治疗前后以及健康对照者进行了评估，以研究混合营养餐后上消化道的功能。甲状腺功能亢进患者的胃分泌、胃排空和胰腺分泌均正常，且餐后通常能正常整合。与健康对照者相比，该组患者的胆汁酸输出减少（P<0.05）。然而，大多数甲状腺功能亢进患者十二指肠胆汁酸浓度高于临界胶束浓度，且所有患者在治疗三个月后胆汁酸输出和浓度均保持不变。放射性碘治疗后，当胃肠道症状恢复正常时，观察到胃分泌有小幅但具有统计学意义的增加。然而，胃排空和胰腺分泌，与胆汁分泌一样，保持不变。甲状腺功能亢进症中导致腹泻和脂肪泻的异常似乎主要位于十二指肠远端。然而，胆汁酸输出减少可能是部分患者的一个促成因素。
