Schuffler M D, Kaplan L R, Johnson L
Am J Dig Dis. 1978 Sep;23(9):821-8. doi: 10.1007/BF01079792.
The purpose of this investigation was to determine the frequency and severity of small intestinal mucosal damage in pseudoobstruction syndromes. One hundred eighty-nine interpretable biopsies from 12 patients were blindly reviewed by two investigators. The underlying disorders were scleroderma in 7 and idiopathic intestinal pseudoobstruction in 5. All 12 had small-intestinal dilatation on small-bowel series. Eight of the 12 patients had biopsies characterized by moderate to severe mucosal damage; 3 of these had some biopsies which were flat. The damage did not correlate with: (1) types and numbers of organisms recovered from small intestinal aspirates; (2) duration of illness; (3) degree of dilatation of the proximal small bowel; (4) concentrations of deconjugated bile salts in small intestinal fluid; or (5) amount of fat absorbed in fat-balance studies. We conclude that mucosal damage is common in pseudoobstruction syndromes. The pathogenesis of the damage and its relationship to intraluminal bacteria remain undefined.
本研究的目的是确定假性肠梗阻综合征中小肠黏膜损伤的频率和严重程度。两名研究者对12例患者的189份可解读的活检标本进行了盲法评估。潜在疾病为硬皮病7例，特发性肠假性梗阻5例。所有12例患者小肠造影均显示小肠扩张。12例患者中有8例活检表现为中度至重度黏膜损伤；其中3例部分活检标本呈扁平状。这种损伤与以下因素无关：（1）从小肠吸出物中培养出的微生物类型和数量；（2）病程；（3）近端小肠扩张程度；（4）小肠液中去结合胆汁盐的浓度；或（5）脂肪平衡研究中吸收的脂肪量。我们得出结论，黏膜损伤在假性肠梗阻综合征中很常见。损伤的发病机制及其与肠腔内细菌的关系尚不清楚。
