Study of ion transport across biopsies of ileostomy in vitro: search for evidence of intestinal 'adaptation' after colectomy.
Study of ion transport across biopsies of ileostomy in vitro: search for evidence of intestinal 'adaptation' after colectomy.
复制标题
体外回肠造口活检中离子传输的研究：寻找结肠切除术后肠道“适应”的证据。
作者：
P. Hawker;A. Morris;J. Mckay;L. Turnberg
为了探讨结肠切除术后小肠“适应”的可能性，我们检测了回肠造口患者的回肠粘膜活检组织在体外转运电解质的能力。回肠造口粘膜电位差（5.4+/-0.5 mV）高于正常粘膜（3.3+/-0.3，P <0.001），电阻更高（98+/-12，对40.3+/-2.8 Ω cm-2），而短路电流更低（54.8+/-6.0;对89.9+/-6.1 muA.cm-2）。净钠吸收为1.25+/-0.41 mumol.cm-2.h-1（n=6），加入葡萄糖（15 mM.1-1）后增加至11.57+/-0.8 mumol.cm-2.h-1（n=4），这些结果与正常回肠的结果相似。净氯转运也与noraml相似。在一例间歇性回肠造口术腹泻受试者中，净钠吸收正常，为2.14 mumol.cm-2.h-1，但有明显的活性氯分泌，为14.03 mumol.cm-2.h-1。这些研究没有提供任何证据表明结肠切除术后回肠粘膜的电解质吸收增强。有些回肠造口腹泻病例可能是由于活性氯化物分泌所致。
To explore the possibility that small intestinal 'adaptation' may occur after colectomy we examined the ability of ileal mucosal biopsies, taken from patients with ileostomies, to transport electrolytes in vitro. Ileostomy mucosal electrical potential difference was higher (5.4+/-0.5 mV) than in normal mucosa (3.3+/-0.3, P less than 0.001), resistance was higher (98+/-12, against 40.3+/-2.8 omega cm-2), while short circuit current was lower (54.8+/-6.0; against 89.9+/-6.1 muA.cm-2). Net sodium absorption, 1.25+/-0.41 mumol.cm-2.h-1 (n=6), rose on addition of glucose (15 mM.1-1) to 11.57+/-0.8 mumol.cm-2.h-1 (n=4), and these were similar to results from normal ileum. Net chloride transport was also similar to noraml. In one subject, with intermittent ileostomy diarrhoea, net sodium absorption was normal, 2.14 mumol.cm-2.h-1, but there was marked active chloride secretion, 14.03 mumol.cm-2.h-1. These studies do not provide any evidence of enhanced electrolyte absorption across ileal mucosa as a response to colectomy. Some cases of ileostomy diarrhoea may be due to active chloride secretion.