Sutherland L R, Verhoef M, Wallace J L, Van Rosendaal G, Crutcher R, Meddings J B
GI Research Group, University of Calgary, Alberta, Canada.
Lancet. 1994 Apr 23;343(8904):998-1000. doi: 10.1016/s0140-6736(94)90125-2.
Disaccharides do not cross intact gastrointestinal mucosa to any appreciable extent unless there is damage to the epithelium. Furthermore, since sucrose is rapidly broken down in the small intestine, the absorption of intact sucrose implies damage to proximal epithelium. We have reported that measurement of sucrose permeability detects gastric damage in animals. Whilst such a non-specific test could not replace endoscopy, it might represent a clinically useful technique to identify patients who would benefit from endoscopy. 189 patients underwent endoscopy and assessment of sucrose permeability to evaluate the effectiveness of increased sucrose permeability in the prediction of endoscopic findings. The endoscopist was blinded to results of the sucrose assay. Gastric damage, particularly ulcers and severe gastritis, was successfully detected with this technique. Increased sucrose permeability, however, did not reliably detect mild gastritis, oesophagitis, or duodenal disease. The sensitivity of the test for gastric ulceration was 84% and specificity in predicting an abnormal endoscopy was 96%. Measurement of sucrose permeability is a simple way of screening for gastric damage. It has a sensitivity similar to that for upper gastrointestinal radiology and provides a new way to effectively screen large populations at risk of gastric damage.
二糖通常不会完整地穿过胃肠道黏膜，除非上皮组织受损。此外，由于蔗糖在小肠中会迅速分解，完整蔗糖的吸收意味着近端上皮组织受损。我们曾报道，测量蔗糖渗透性可检测出动物的胃损伤。虽然这种非特异性检测无法替代内镜检查，但它可能是一种临床上有用的技术，可用于识别那些能从内镜检查中获益的患者。189名患者接受了内镜检查及蔗糖渗透性评估，以评估蔗糖渗透性增加在预测内镜检查结果方面的有效性。内镜检查医生对蔗糖检测结果不知情。通过这项技术成功检测出了胃损伤，尤其是溃疡和严重胃炎。然而，蔗糖渗透性增加并不能可靠地检测出轻度胃炎、食管炎或十二指肠疾病。该检测对胃溃疡的敏感性为84%，预测内镜检查异常的特异性为96%。测量蔗糖渗透性是筛查胃损伤的一种简单方法。它的敏感性与上消化道放射学检查相似，为有效筛查有胃损伤风险的大量人群提供了一种新方法。
