Gastroduodenal and intestinal permeability in primary biliary cirrhosis
Gastroduodenal and intestinal permeability in primary biliary cirrhosis
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DOI：
10.1097/01.meg.0000085466.12407.e9
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发表时间：
2003-09-01
影响因子：
2.1
通讯作者：
Floreani, A
中科院分区：
文献类型：
--
作者：
Di Leo, V;Venturi, C;Floreani, A
目的探讨原发性胆汁性肝硬化（PBC）患者胃肠道通透性与马约评分、组织学分期、腹水、自发性细菌性腹膜炎、内镜下门静脉高压症和幽门螺杆菌感染的关系。最初排除了所有参与者的腹腔疾病。结果PBC患者和非PBC患者的蔗糖排泄量均高于正常值。22%的PBC患者的乳果糖-甘露醇试验结果升高，而非PBC患者的乳果糖-甘露醇试验结果升高率为12.8%。PBC患者有高蔗糖排泄水平，无论是否存在任何食管静脉曲张，显着增加胃十二指肠通透性在非PBC患者只有当与高血压性胃病。高血压性胃病使非PBC患者的蔗糖排泄量显著增加（P < 0.001），而PBC患者的蔗糖排泄量无显著变化。两组患者胃肠通透性与其他参数均无显著相关性。结论PBC患者胃肠通透性增高。门静脉高压导致非PBC肝硬化患者胃粘膜通透性改变，而PBC患者胃粘膜上皮功能障碍不同。(C)2003年利平科特威廉姆斯威尔金斯。
Objectives To evaluate gastrointestinal permeability in primary biliary cirrhosis (PBC), using a sensitive method to detect epithelial damage, and to correlate it with the Mayo score, histological stage, ascites, spontaneous bacterial peritonitis, endoscopic signs of portal hypertension and Helicobacter pylori infection.Methods Fifty consecutive patients with PBC and 39 patients with cirrhosis of other aetiologies (non-PBC) were enrolled in the study. Coeliac disease was initially ruled out in all participants. Permeability was assessed using sucrose (gastro-duodenum) and lactulose-mannitol (intestine).Results Sucrose excretion was above the limit in both PBC and non-PBC patients. Twenty-two per cent of PBC patients had an increased result for the lactulose-mannitol test compared to 12.8% of non-PBC cirrhotic patients. PBC patients had high sucrose excretion levels irrespective of the presence of any oesophageal varices, which significantly increased the gastroduodenal permeability in non-PBC patients only when associated with hypertensive gastropathy. Sucrose excretion was significantly enhanced by hypertensive gastropathy in non-PBC patients (P < 0.001) but not in PBC patients. No significant correlation was found in either group between gastrointestinal permeability and the other parameters.Conclusions Gastrointestinal permeability is increased in PBC. Portal hypertension contributes to altered gastric mucosal permeability in non-PBC cirrhosis, whereas different epithelial dysfunction can be hypothesized in PBC. (C) 2003 Lippincott Williams Wilkins.