van Elburg R M, Kokke F T, Uil J J, Mulder C J, de Monchy J G, Heymans H S
Beatrix Kinderkliniek, Academisch Ziekenhuis, Groningen.
Ned Tijdschr Geneeskd. 1993 Oct 9;137(41):2091-5.
To study the clinical value of the sugar absorption test (SAT) as a function test of the selective permeability of the small intestine in various intestinal diseases.
Inventory of the results of the SAT in a number of patient groups and controls.
Beatrix Children's Hospital, Groningen and Rijnstate Hospital, Arnhem.
The SAT was performed in 51 controls (25 children, 26 adults) and in a number of diseases: (suspected) allergy to cow's milk albumin (30 children), (suspected) coeliac disease (86 children and 35 adults), Crohn's disease (25 patients) with ulcerative colitis (9), and pancreatic insufficiency (31) due to cystic fibrosis or chronic pancreatitis. For the SAT, the fasting patient is given a solution of mannitol (M) and lactulose (L) following which the L/M ratio, as an indicator of the selective intestinal permeability, is determined in 5-hour urine by means of gas chromatography.
In cow's milk protein allergy, the L/M ratio showed a statistically significant increase in clinically positive cow's milk provocation results, unlike that in clinically negative results. After pretreatment with cromoglycate this difference decreased to non-significant values. The L/M ratio was increased in active coeliac disease (with villous atrophy), first-degree relatives of coeliac disease patients, Crohn's disease, clinically active ulcerative colitis and pancreatic insufficiency. The L/M ratio was not increased in inactive coeliac disease (with normal villi), suspicion of coeliac disease because of short stature, dystrophy and/or aspecific gastrointestinal symptoms with normal villi, and in clinically inactive ulcerative colitis.
The selective intestinal permeability can be determined by means of the SAT. This could be an important tool for diagnosis and evaluation of therapy in gastrointestinal disorders.
研究糖吸收试验（SAT）作为小肠选择性通透性功能试验在各种肠道疾病中的临床价值。
对多个患者组和对照组的SAT结果进行汇总。
格罗宁根市贝娅特丽克丝儿童医院和阿纳姆市莱茵斯泰特医院。
对51名对照者（25名儿童，26名成人）以及多种疾病患者进行了SAT：（疑似）牛奶白蛋白过敏（30名儿童）、（疑似）乳糜泻（86名儿童和35名成人）、克罗恩病（25例患者）合并溃疡性结肠炎（9例）以及由囊性纤维化或慢性胰腺炎导致的胰腺功能不全（31例）。进行SAT时，空腹患者先服用甘露醇（M）和乳果糖（L）溶液，然后通过气相色谱法测定5小时尿液中的L/M比值，以此作为肠道选择性通透性的指标。
在牛奶蛋白过敏中，与临床阴性结果不同，临床阳性牛奶激发试验结果的L/M比值有统计学意义的升高。用色甘酸预处理后，这种差异减小至无统计学意义。活动性乳糜泻（伴有绒毛萎缩）、乳糜泻患者的一级亲属、克罗恩病、临床活动性溃疡性结肠炎和胰腺功能不全患者的L/M比值升高。非活动性乳糜泻（绒毛正常）、因身材矮小、营养不良和/或有非特异性胃肠道症状且绒毛正常而疑似乳糜泻的患者以及临床非活动性溃疡性结肠炎患者的L/M比值未升高。
可通过SAT测定肠道选择性通透性。这可能是胃肠道疾病诊断和治疗评估的重要工具。
