慢性腹泻肠黏膜形态和通透性研究

目的探讨慢性腹泻患者肠黏膜形态和通透性的变化。方法对33例慢性腹泻患者和30名健康志愿者行结肠镜检查，并在镜下取回肠末端和回盲部黏膜各3块，光镜下观察肠黏膜的组织结构，同时测定尿中的乳果糖／甘露醇（L／M）比值，以评价肠黏膜屏障功能。结果慢性腹泻患者光镜下可见回肠末端有绒毛顶端上皮细胞水肿、脱落，但与健康志愿者差异无统计学意义（P〉0．05）；回盲部可见被覆上皮细胞明显水肿、脱落和破溃，甚至被覆上皮细胞成片完全脱落，与健康志愿者比较差异有统计学意义（P〈0。05）。慢性腹泻患者和健康志愿者尿L／M比值差异无统计学意义（P〉0．05）。结论慢性腹泻患者可能存在结肠黏膜屏障损害。

Study of intestinal mucosa structure and permeability in chronic diarrhea

Objective To explore the alterations of intestinal mucosa structure and permeability in chronic diarrhea.Methods 33 chronic diarrhea patients and 30 healthy volunteers were taken coloscopy,and got 3 pieces mucosa in terminal ileum and ileocecal junction each.The intestinal mucosa structure was detected by histopathological examination with light microscope.Gut barrier dysfunction was evaluated by detecting urine lactulose / mannitol(L/M) ratio.Results Endothelial cells in top of villi of terminal ileum were hydropsia,defluxion in chronic diarrhea patients,but there was not significant difference with healthy volunteers(P>0.05);Covering epithelium cells in ileocecal junction obviously hydropsia,defluxion and defeated,even defluxion fully,there was significant difference with healthy volunteers(P<0.05);And there was not significant difference in urine L/M ratio between chronic diarrhea and healthy volunteers(P>0.05).Conclusion Chronic diarrhea maybe exist colon barrier dysfunction.