Hylander E, Jarnum S, Jensen H J, Thale M
Scand J Gastroenterol. 1978;13(5):577-88. doi: 10.3109/00365527809181767.
The importance of intestinal resection, exclusion of the colon, and steatorrhoea for secondary hyperoxaluria was studied in 81 patients with Crohn's disease and 12 patients with ileostomy after colectomy for ulcerative colitis during a metabolic regime including a fixed oral supply of fat, calcium, and oxalate. Hyperoxaluria (greater than 48 mg (greater than 0.5 mmol) per 24 h) was present in 21 patients with Crohn's disease. All but one half or more of the colon preserved. Renal oxalate excretion was related to the amount of ileum resected. 14C-oxalate absorption was significantly higher in patients with ileal resection and the whole colon preserved than in patients with ileal resection plus hemicolectomy, despite the fact that the latter group had the most extensive ileal resections. Faecal fat and oxalate excretion agreed well in patients without ileostomy (r = 0.76, p less than 0.001), and renal oxalate excretion was significantly higher in patients with steatorrhea and the colon preserved than in patients without steatorrhoea. In all 93 patients 14C-oxalate absorption and renal oxalate excretion was positively correlated with a coefficient of correlation of 0.76 (p less than 0.001). No correlation was present between 47Ca- and 14C-oxalate absorption. The study confirm that a preserved colon is necessary for secondary hyperoxaluria and stresses the importance of ileal resection and steatorrhoea.
在一项代谢研究中，对81例克罗恩病患者和12例因溃疡性结肠炎行结肠切除术后行回肠造口术的患者，研究了肠切除、结肠旷置和脂肪泻对继发性高草酸尿症的影响，该代谢研究包括固定的口服脂肪、钙和草酸盐供应。21例克罗恩病患者存在高草酸尿症（每24小时大于48毫克（大于0.5毫摩尔））。除1例患者外，其余患者保留了一半或更多的结肠。肾草酸排泄与切除的回肠量有关。尽管后一组患者的回肠切除范围最广，但保留全结肠的回肠切除患者的14C-草酸盐吸收明显高于回肠切除加半结肠切除的患者。在无回肠造口术的患者中，粪便脂肪和草酸盐排泄高度相关（r = 0.76，p < 0.001），保留结肠的脂肪泻患者的肾草酸排泄明显高于无脂肪泻的患者。在所有93例患者中，14C-草酸盐吸收与肾草酸排泄呈正相关，相关系数为0.76（p < 0.001）。47Ca-草酸盐吸收与14C-草酸盐吸收之间无相关性。该研究证实，保留结肠对继发性高草酸尿症是必要的，并强调了回肠切除和脂肪泻的重要性。
