[儿童小肠活检研究结果及其与乳糜泻相关的其他临床旁发现的相关性]。

J Henker
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摘要

1970年至1983年,在德累斯顿医学院儿童医院进行了1 000例成功的肠道活检。无穿孔、出血等并发症。经口肠活检在乳糜泻的诊断中具有重要意义。乳糜泻患儿的某些临床旁参数与可记录的小肠黏膜变化相关;网状蛋白抗体和谷蛋白抗体均不能作为经口肠道活检的筛查参数。网状蛋白抗体的测定更适合于饮食检查,因为它具有更大的特异性。在乳糜泻的急性期,预计50%的病例血清锌水平下降。建议短期补锌。乳糜泻患儿病理性脑电图增多;尤其是在长期吃含谷蛋白的食物之后。因此麸质激发诊断乳糜泻应该在6岁以后进行,这是在脑细胞分化完成之后。
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[Results of small intestinal biopsy studies in childhood and their correlation to other paraclinical findings with special reference to celiac disease].

From 1970 to 1983 1,000 successful peroral intestinal biopsies were carried out at the children's Hospital of the Medical Academy Dresden. No complications such as perforation or bleeding appeared. Peroral intestinal biopsy has a preeminent importance in the diagnostic of coeliac disease. Certain paraclinical parameters in children with coeliac disease were correlated with bioptically recordable small intestinal mucosa changes; from which following results and conclusions can be drawn: Neither reticulin nor gluten antibodies can be recommended as screening parameters for the peroral intestinal biopsy. The determination of reticulin antibodies is better suited for diet checking because of its greater specificity . During the acute phase of coeliac disease 50 per cent of the cases are to be expected to have decreased serum zinc levels. A short-term zinc substitution is to be recommended. An increased number of pathological EEG's can be found in children with coeliac disease; particularly after a longterm gluten-containing diet. Therefore gluten-provocation to diagnose a coeliac disease should be performed after the 6th year of life, this is after completion of the cerebral cell differentiation.

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