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目的前瞻性研究胃癌癌性营养不良病人肠黏膜通透性的变化及其与C反应蛋白(CRP)的关系。方法选取2003年1月至2004年5月南京军区南京总医院普外科收治的进展期胃癌病人30例,营养不良者15例,营养正常者15例。口服含乳果糖10g、甘露醇5g的测试液,收集服药后6h全部尿液,用高效液相色谱法测定尿中乳果糖和甘露醇排泄率的比值(L/M)。同时测定血清中CRP浓度。结果营养正常者L/M为(0.049±0.010),营养不良病人L/M为(0.161±0.141),营养不良病人尿中L/M明显增高(P<0.01),L/M升高者血清CRP明显高于L/M正常者且差异具有显著性意义(P<0.05)。结论胃癌营养不良病人肠黏膜通透性明显升高,该现象与炎性反应相关。
Objective To prospectively study the changes of intestinal mucosal permeability and its relationship with C-reactive protein (CRP) in patients with gastric cancer with malnutrition. Methods From January 2003 to May 2004, Nanjing General Hospital of Nanjing Military Region General Surgery admitted 30 cases of advanced gastric cancer patients, malnutrition in 15 cases, 15 cases of normal nutrition. Oral administration of test solution containing 10g of lactulose and 5g of mannitol, all the urine samples were collected at 6h after administration. The ratio of lactulose to mannitol excretion (L / M) in urine was determined by high performance liquid chromatography. Simultaneous determination of serum CRP concentration. Results L / M was (0.049 ± 0.010) in normal nutrition group, L / M was (0.161 ± 0.141) in malnutrition patients, L / M was significantly higher in malnourished patients (P <0.01) CRP was significantly higher than L / M normal and the difference was significant (P <0.05). Conclusions Gastric mucosa malnutrition patients with intestinal mucosal permeability was significantly increased, the phenomenon associated with inflammatory reaction.