Püspök A, Oberhuber G, Wyatt J, Maier-Dobersberger T, Hammer J, Pfeffel F, Wrba F, Pötzi R, Vogelsang H
Department of Gastroenterology and Hepatology, University of Vienna, Austria.
Eur J Clin Invest. 1998 Jan;28(1):67-71. doi: 10.1046/j.1365-2362.1998.00241.x.
Gastric permeability was prospectively investigated by determination of sucrose excretion in 100 patients with Crohn's disease. Results were compared with histological findings and the lactulose-mannitol ratio as a measure of intestinal permeability.
All subjects underwent oesophagogastroduodenoscopy with biopsies of all investigated parts. Thirty-two Helicobacter pylori-positive patients were excluded from further analyses.
Gastroduodenal permeability was significantly higher in patients with Crohn's disease than in control subjects (P < 0.00001). Sucrose excretion alone did not predict microscopic inflammation of the upper gastrointestinal tract. Increased gastroduodenal permeability with a concomitant rise in intestinal permeability predicted histological upper gastrointestinal involvement of Crohn's disease with a likelihood of 86%. The negative predictive value was 43%.
In parallel with findings in the small intestine, gastroduodenal permeability is increased in a high proportion of patients with Crohn's disease. In patients with an increased lactulose-mannitol ratio, elevated sucrose excretion is highly predictive of histological gastroduodenal involvement.
通过测定100例克罗恩病患者的蔗糖排泄量，对胃通透性进行前瞻性研究。将结果与组织学检查结果以及作为肠通透性指标的乳果糖-甘露醇比率进行比较。
所有受试者均接受食管胃十二指肠镜检查，并对所有检查部位进行活检。32例幽门螺杆菌阳性患者被排除在进一步分析之外。
克罗恩病患者的胃十二指肠通透性显著高于对照组（P < 0.00001）。仅蔗糖排泄量不能预测上消化道的微观炎症。胃十二指肠通透性增加且肠通透性同时升高，预测克罗恩病组织学上消化道受累的可能性为86%。阴性预测值为43%。
与小肠的研究结果相似，高比例的克罗恩病患者存在胃十二指肠通透性增加。在乳果糖-甘露醇比率升高的患者中，蔗糖排泄量升高高度提示组织学上胃十二指肠受累。
