Vogelsang H, Oberhuber G, Wyatt J
Department of Gastroenterology and Hepatology, University Clinic of Internal Medicine IV, Vienna, Austria.
Gastroenterology. 1996 Jul;111(1):73-7. doi: 10.1053/gast.1996.v111.pm8698227.
BACKGROUND & AIMS: Lymphocytic gastritis is associated with celiac disease. Gastric permeability can now be assessed by a sucrose test, and intestinal permeability measured by a lactulose/mannitol test is increased in untreated celiac patients. The aim of this study was to prospectively compare gastric and intestinal permeability with histological changes of the stomach and small bowel in patients with celiac disease.
Gastric and intestinal permeability were measured by oral or duodenal (during endoscopy) administration of a triple sugar solution containing 20 g sucrose, 10 g lactulose, and 5 g mannitol in 100 mL water in 43 adult patients with celiac disease (28 without diet) and in 30 healthy controls. Endoscopical biopsy specimens were taken from the antrum and distal duodenum and investigated for intraepithelial lymphocyte counts.
Urinary sucrose excretion decreased after duodenal administration (n = 8) as opposed to oral administration and thus measured gastric permeability in celiac disease. Gastric permeability was elevated in 60% of the celiac patients and correlated with antral intraepithelial lymphocyte counts. Intestinal permeability (measured by a lactulose/mannitol test) was also elevated in 69% of the celiac patients and correlated with duodenal intraepithelial counts.
There is a high prevalence of lymphocytic gastritis in untreated celiac disease associated with elevated gastric permeability. Celiac disease seems to be a general disorder of the gastrointestinal tract associated with disturbed permeability.
淋巴细胞性胃炎与乳糜泻相关。目前可通过蔗糖试验评估胃通透性，未经治疗的乳糜泻患者经乳果糖/甘露醇试验测得的肠道通透性增加。本研究的目的是前瞻性比较乳糜泻患者的胃和肠道通透性与胃及小肠的组织学变化。
在43例成年乳糜泻患者（28例未控制饮食）和30例健康对照者中，通过口服或十二指肠内（内镜检查时）给予含20 g蔗糖、10 g乳果糖和5 g甘露醇的三糖溶液（溶于100 mL水中）来测量胃和肠道通透性。从胃窦和十二指肠远端取内镜活检标本，检测上皮内淋巴细胞计数。
与口服给药相比，十二指肠给药后（n = 8）尿蔗糖排泄减少，从而测得乳糜泻患者的胃通透性。60%的乳糜泻患者胃通透性升高，且与胃窦上皮内淋巴细胞计数相关。69%的乳糜泻患者肠道通透性（通过乳果糖/甘露醇试验测量）也升高，且与十二指肠上皮内计数相关。
未经治疗的乳糜泻患者中淋巴细胞性胃炎的患病率较高，且与胃通透性升高有关。乳糜泻似乎是一种与通透性紊乱相关的胃肠道全身性疾病。
