CORRELATION OF INTESTINAL LACTULOSE PERMEABILITY WITH EXOCRINE PANCREATIC DYSFUNCTION

被引:22
作者
MACK, DR
FLICK, JA
DURIE, PR
ROSENSTEIN, BJ
ELLIS, LE
PERMAN, JA
机构
[1] JOHNS HOPKINS UNIV, SCH MED, DEPT PEDIAT, BALTIMORE, MD 21205 USA
[2] HOSP SICK CHILDREN, RES INST, DIV GASTROENTEROL, TORONTO M5G 1X8, ONTARIO, CANADA
[3] UNIV TORONTO, DEPT PEDIAT, TORONTO M5S 1A1, ONTARIO, CANADA
关键词
D O I
10.1016/S0022-3476(05)80230-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Increased intestinal permeability to lactulose has been reported in patients with cystic fibrosis (CF). To determine whether this finding is unique to CF or whether it is related to accompanying exocrine Pancreatic dysfunction, we evaluated 31 patients with CF and 10 with Shwachman syndrome who had variable degrees of pancreatic dysfunction, together with 17 healthy control subjects. There was no significant difference in the mean urinary lactulose excretion, expressed as the percentage of dose recovered, between CF and non-CF patients with pancreatic insufficiency (2.1% +/- 1.2% and 1.9% +/- 0.8%, respectively) or between CF and non-CF patients with pancreatic sufficiency (0.6% +/- 0.5% and 0.6% +/- 0.3%, respectively). However, there was a significant difference in mean lactulose excretion between the pancreatic-insufficient and the pancreatic-sufficient patients (both CF and non-CF groups; p < 0.001 and p < 0.013, respectively). We further analyzed the results from 26 of the 41 patients (16 patients with CF and 10 non-CF patients) with pancreatic dysfunction who had previously undergone quantitative pancreatic function testing. A nonlinear, inverse relationship was found between urinary lactulose excretion and exocrine pancreatic function determined by duodenal trypsin output. These data confirm a direct relationship between intestinal lactulose permeability and the degree of exocrine pancreatic dysfunction, unrelated to the cause of the pancreatic disease.
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页码:696 / 701
页数:6
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