Effect of glucocorticoids on rectal transport in normal subjects and patients with ulcerative colitis.
Effect of glucocorticoids on rectal transport in normal subjects and patients with ulcerative colitis.
复制标题
糖皮质激素对正常人和溃疡性结肠炎患者直肠运输的影响。
作者：
Sandle,GI;Hayslett,JP;Binder,HJ
采用透析技术，研究了单剂量糖皮质激素对直肠净电解质和水转运及电位差（pd）的急性影响，研究对象包括对照受试者和活动性或非活动性溃疡性结肠炎患者。与17名对照组相比，9名活动性溃疡性结肠炎患者的净钠吸收和直肠pd明显下降，而6名非活动性溃疡性结肠炎患者的这些转运参数正常。5小时后静脉注射半环酸氢化可的松（100mg）， 9名对照受试者、7名活动性溃疡性结肠炎患者和6名非活动性溃疡性结肠炎患者的净钠和水吸收量和pd显著增加，且数量相似。8名对照受试者静脉注射磷酸甲基强的松龙（40mg）后，5小时后净钠和水吸收量及pd增加，与氢化可的松没有显著差异；甲强的松龙在两例活动性溃疡性结肠炎患者中引起了类似的变化。这些结果表明，单剂量糖皮质激素刺激对照组和急性溃疡性结肠炎患者直肠钠和水吸收的急性增加。因此，全身给药糖皮质激素减少溃疡性结肠炎腹泻的能力可能与对结肠远端钠和水运输的直接影响以及其更广为人知的抗炎作用有关。
The acute effects of single pharmacological doses of glucocorticoid hormones on net electrolyte and water transport and electrical potential difference (pd) in the rectum was studied in control subjects and in patients with either active or inactive ulcerative colitis, using a dialysis technique. Compared with 17 control subjects, nine patients with active ulcerative colitis exhibited marked decreases in net sodium absorption and rectal pd, while these transport parameters were normal in six patients with inactive ulcerative colitis. Intravenous administration of hydrocortisone hemisuccinate (100 mg) resulted five hours later in significant and quantitatively similar increases in net sodium and water absorption and pd in nine control subjects, seven patients with active ulcerative colitis, and six patients with inactive ulcerative colitis. Intravenous administration of methylprednisolone phosphate (40 mg) to eight control subjects produced increases in net sodium and water absorption and pd five hours later, which did not differ significantly from those produced by hydrocortisone; methylprednisolone induced similar changes in two patients with active ulcerative colitis. These results indicate that single pharmacological doses of glucocorticoids stimulate acute increases in rectal sodium and water absorption in control subjects and in patients with acute ulcerative colitis. The ability of systemically administered glucocorticoids to reduce diarrhoea in ulcerative colitis may therefore be related to direct effects on distal colonic sodium and water transport, as well as to their better known anti-inflammatory action.