可控性回肠造口术患者胆汁酸和胆固醇的回肠排泄及细菌修饰作用
Ileal excretion and bacterial modification of bile acids and cholesterol in patients with continent ileostomy.
作者信息
Kay R M, Cohen Z, Siu K P, Petrunka C N, Strasberg S M
出版信息
Gut. 1980 Feb;21(2):128-32. doi: 10.1136/gut.21.2.128.
Bile acid (acidic sterol) and neutral steroid excretion were determined in 15 patients, five with conventional ileostomy, five with continent ileostomy, and five with continent ileostomy and an ileal resection. Acidic sterol losses were normal in conventional ileostomy patients and not significantly increased in those with continent ileostomy alone. Bile acid excretion rates were significantly increased in patients with a continent ileostomy and an ileal resection. Neutral steroid excretion was similar in all groups and not different from normal. Deoxycholic acid was not detected in ileal effluent of patients with conventional ileostomy and less than 2% of neutral steroid excreted was in the form of bacterial metabolites of cholesterol. The same was true of six of the 10 patients with continent ileostomies; in the other four patients at least 10% of acidic or neutral steroids were excreted as secondary bile acids or as a coprostanol. Modification of steroids was not related to ileal resection. Continent ileostomy was associated with a significant increase in percentage water content and a reduction in the pH of ileal effluent.
对15例患者的胆汁酸（酸性固醇）和中性类固醇排泄情况进行了测定，其中5例为传统回肠造口术患者，5例为可控性回肠造口术患者，5例为可控性回肠造口术并伴有回肠切除术患者。传统回肠造口术患者的酸性固醇损失正常，仅行可控性回肠造口术的患者酸性固醇损失未显著增加。行可控性回肠造口术并伴有回肠切除术的患者胆汁酸排泄率显著增加。所有组的中性类固醇排泄情况相似，与正常情况无差异。在传统回肠造口术患者的回肠流出物中未检测到脱氧胆酸，排泄的中性类固醇中以胆固醇细菌代谢产物形式存在的不到2%。10例可控性回肠造口术患者中有6例情况相同；在其他4例患者中，至少10%的酸性或中性类固醇以次级胆汁酸或粪甾烷醇的形式排泄。类固醇的改变与回肠切除术无关。可控性回肠造口术与回肠流出物含水量百分比显著增加及pH值降低有关。
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