Pereira Prue M, Bines Julie E
Murdoch Children's Research Institute, Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
J Gastroenterol Hepatol. 2006 Jun;21(6):932-40. doi: 10.1111/j.1440-1746.2006.04351.x.
Short bowel syndrome (SBS) is used to describe a condition of malabsorption and malnutrition resulting from the loss of absorptive area following massive small bowel resection. The key to improved clinical outcome after massive small bowel resection is the ability of the residual bowel to adapt. Although still in experimental stages, a major goal in the management of SBS may be the augmented use of growth factors to promote increased adaptation. A number of growth factors have been implicated in promoting the adaptation process. The best-described growth factors are reviewed: glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF), and growth hormone (GH). This article reviews the ability of recombinant GLP-2, EGF and GH to modulate structural and functional aspects of intestinal adaptation following small bowel resection. Although these growth factors have shown promise, small sample size, inconsistent measurement parameters and uncontrolled study designs have hampered the acquisition of strong data advocating the use of growth factor treatment for SBS. Multicenter trials using well-defined outcome measures to assess clinical efficacy are needed to direct the clinical indications, timing and duration of therapy and assess potential risks associated with growth factor therapies.
短肠综合征（SBS）用于描述因大量小肠切除后吸收面积丧失而导致的吸收不良和营养不良状况。大量小肠切除术后改善临床结局的关键在于残余肠道的适应能力。尽管仍处于实验阶段，但SBS管理的一个主要目标可能是增加生长因子的使用以促进适应性增强。许多生长因子与促进适应过程有关。本文综述了描述最详尽的生长因子：胰高血糖素样肽-2（GLP-2）、表皮生长因子（EGF）和生长激素（GH）。本文回顾了重组GLP-2、EGF和GH调节小肠切除术后肠道适应的结构和功能方面的能力。尽管这些生长因子已显示出前景，但样本量小、测量参数不一致和研究设计无对照阻碍了获取有力数据以支持使用生长因子治疗SBS。需要进行多中心试验，采用明确的结局指标来评估临床疗效，以指导治疗的临床指征、时机和持续时间，并评估与生长因子治疗相关的潜在风险。
