Tepper R E, Simon D, Brandt L J, Nutovits R, Lee M J
Division of Gastroenterology, Bronx Municipal Hospital Center, New York.
Am J Gastroenterol. 1994 Jun;89(6):878-82.
The etiology of acquired immunodeficiency syndrome (AIDS) enteropathy is unknown. This condition has been associated with malabsorption and villous atrophy. Other disorders with similar findings, including celiac disease, are characterized by altered intestinal permeability. Our objective was to confirm (or reject) our hypothesis that processes that cause increased permeability may occur in patients with AIDS, and thus be a cause of idiopathic diarrhea.
A lactulose-mannitol differential intestinal permeability test was performed in healthy controls, asymptomatic human immunodeficiency virus (HIV)-positive patients, and AIDS patients with and without diarrhea.
Asymptomatic HIV-positive patients lactulose and mannitol recoveries were no different than healthy control patients. AIDS patients without diarrhea had lactulose recovery similar to healthy controls and decreased mannitol recoveries; their mean lactulose:mannitol ratio was no different from that of controls, and less than that of AIDS patients with diarrhea. AIDS patients with diarrhea had increased lactulose recovery and decreased mannitol recovery; their mean lactulose:mannitol ratio was significantly greater than the ratios in all the other groups.
Patients with AIDS and diarrhea have altered intestinal permeability. The decreased absorption of mannitol suggests that the functional absorptive surface of the intestine decreases as HIV disease progresses.
获得性免疫缺陷综合征（艾滋病）肠病的病因尚不清楚。这种情况与吸收不良和绒毛萎缩有关。其他具有类似表现的疾病，包括乳糜泻，其特征是肠道通透性改变。我们的目的是证实（或否定）我们的假设，即导致通透性增加的过程可能发生在艾滋病患者中，从而成为特发性腹泻的一个原因。
对健康对照者、无症状人类免疫缺陷病毒（HIV）阳性患者以及有腹泻和无腹泻的艾滋病患者进行乳果糖-甘露醇差异性肠道通透性试验。
无症状HIV阳性患者的乳果糖和甘露醇回收率与健康对照患者无差异。无腹泻的艾滋病患者的乳果糖回收率与健康对照者相似，甘露醇回收率降低；他们的平均乳果糖：甘露醇比值与对照组无差异，且低于有腹泻的艾滋病患者。有腹泻的艾滋病患者乳果糖回收率增加，甘露醇回收率降低；他们的平均乳果糖：甘露醇比值显著高于所有其他组。
患有腹泻的艾滋病患者肠道通透性发生改变。甘露醇吸收减少表明随着HIV疾病进展，肠道的功能性吸收表面减少。
