Sigalet David L, Lam Viona, Boctor Dana
Alberta Children's Hospital Intestinal Rehabilitation Program, Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada.
Semin Pediatr Surg. 2010 Feb;19(1):44-9. doi: 10.1053/j.sempedsurg.2009.11.005.
The treatment of patients with short bowel syndrome is hampered by a lack of treatment and measurement methods. This article reviews our evolving understanding of the role of glucagon-like peptide 2 (GLP-2) in controlling the adaptive process. The ability of the remnant intestine to produce GLP-2 appears to be predictive of the adaptive process; exogenous GLP-2 may be a therapy to augment adaptation. Strategies for monitoring patients, including conventional means, such as anthropomorphic measurements, plasma levels of specific nutrients, and vitamins and radiological contrast studies are reviewed. Investigational methods, such as nutrient balance studies, plasma citrulline levels, and the absorption of inert sugars (3-0 methyl glucose, mannitol, and lactulose) are discussed with the evidence to support their use.
治疗方法和测量手段的匮乏阻碍了短肠综合征患者的治疗。本文回顾了我们对胰高血糖素样肽2（GLP-2）在控制适应性过程中作用的不断演变的认识。残余肠道产生GLP-2的能力似乎可预测适应性过程；外源性GLP-2可能是增强适应性的一种治疗方法。本文还回顾了监测患者的策略，包括传统手段，如人体测量、特定营养素和维生素的血浆水平以及放射学造影研究。文中讨论了研究方法，如营养平衡研究、血浆瓜氨酸水平以及惰性糖（3-0甲基葡萄糖、甘露醇和乳果糖）的吸收情况，并给出了支持其应用的证据。
