Pironi L, Paganelli G M, Miglioli M, Biasco G, Santucci R, Ruggeri E, Di Febo G, Barbara L
Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
JPEN J Parenter Enteral Nutr. 1994 Jul-Aug;18(4):351-4. doi: 10.1177/014860719401800413.
The morphologic and cytoproliferative patterns of the duodenal mucosa of two adult patients, one of whom had a short bowel, were evaluated after more than 2 months of postoperative total parenteral nutrition and 2 and 12 months after the resumption of oral alimentation. Morphometric analysis was performed on routinely processed duodenal biopsies. Cell proliferation was evaluated by means of in vitro bromodeoxyuridine uptake. The results were compared with those obtained in five healthy controls. After parenteral nutrition, patients showed significantly lower villus height and crypt depth than those of controls and a normal bromodeoxyuridine labeling index. After 2 months of refeeding, villus and crypt returned to normal, and the labeling index was increased. After 12 months of oral refeeding, labeling index, villus height, and crypt depth were similar to those of controls. The patient with the short bowel showed a number of cells per unit length of villus and crypt significantly greater than those of the controls and of the patient who underwent shorter intestinal resection. In human duodenal mucosa, (1) hypoplasia develops after long-term total parenteral nutrition; (2) mucosal recovery occurs through an increased cell proliferation after oral refeeding; and (3) extensive small bowel resection determines the development of relative hyperplasia.
对两名成年患者十二指肠黏膜的形态学和细胞增殖模式进行了评估，其中一名患者患有短肠综合征。评估时间为术后全肠外营养2个多月后，以及恢复经口进食2个月和12个月后。对常规处理的十二指肠活检组织进行形态计量分析。通过体外溴脱氧尿苷摄取评估细胞增殖。将结果与五名健康对照者的结果进行比较。肠外营养后，患者的绒毛高度和隐窝深度显著低于对照组，但溴脱氧尿苷标记指数正常。再喂养2个月后，绒毛和隐窝恢复正常，标记指数增加。经口再喂养12个月后，标记指数、绒毛高度和隐窝深度与对照组相似。短肠患者每单位长度绒毛和隐窝中的细胞数量显著多于对照组以及接受较短肠切除术的患者。在人十二指肠黏膜中，（1）长期全肠外营养后会发生发育不全；（2）经口再喂养后通过细胞增殖增加实现黏膜恢复；（3）广泛的小肠切除会导致相对增生的发生。
