GI Motility Program, Cedars-Sinai Medical Center, 8730 Alden Drive, Los Angeles, CA 90048, USA.
Neurogastroenterol Motil. 2011 Aug;23(8):739-e328. doi: 10.1111/j.1365-2982.2011.01723.x. Epub 2011 May 10.
Short bowel syndrome (SBS) is a serious clinical disorder characterized by diarrhea and nutritional deprivation. Glucagon-like peptide-1 (GLP-1) is a key hormone, produced by L-cells in the ileum, that regulates proximal gut transit. When extensive ileal resection occurs, as in SBS, GLP-1 levels may be deficient. In this study, we test whether the use of GLP-1 agonist exenatide can improve the nutritional state and intestinal symptoms of patients with SBS.
Five consecutive patients with SBS based on ≤90 cm of small bowel and clinical evidence of nutritional deprivation were selected. Baseline SBS symptoms, demographic and laboratory data were obtained. Antroduodenal manometry was performed on each subject. Each patient was then started on exenatide and over the following month, the baseline parameters were repeated.
The subjects consisted of four males and one female, aged 46-69 years. At baseline, all had severe diarrhea that ranged from 6 to 15 bowel movements per day, often occurring within minutes of eating. After exenatide, all five patients had immediate improvement in bowel frequency and form; bowel movements were no longer meal-related. Total parenteral nutrition was stopped successfully in three patients. Antroduodenal manometry revealed continuous low amplitude gastric contractions during fasting which completely normalized with exenatide.
CONCLUSIONS & INFERENCES: Exenatide is a novel and safe treatment option for SBS. It produced substantial improvement in the bowel habits, nutritional status and quality of life of SBS patients. Successful treatment with exenatide may significantly reduce the need for parenteral nutrition and small bowel transplant.
短肠综合征（SBS）是一种严重的临床疾病，其特征为腹泻和营养缺失。胰高血糖素样肽-1（GLP-1）是一种关键激素，由回肠中的 L 细胞产生，可调节近端肠道转运。当发生广泛的回肠切除时，如 SBS 中那样，GLP-1 水平可能会不足。在这项研究中，我们测试了 GLP-1 激动剂 exenatide 的使用是否可以改善 SBS 患者的营养状况和肠道症状。
选择了五名连续的 SBS 患者，其标准为 ≤90cm 的小肠和临床证据表明存在营养缺失。获得每位患者的 SBS 症状、人口统计学和实验室数据。对每位患者进行胃十二指肠测压。每位患者开始接受 exenatide 治疗，在接下来的一个月中，重复基础参数。
受试者由四名男性和一名女性组成，年龄为 46-69 岁。基线时，所有患者均有严重腹泻，每天排便 6-15 次，经常在进食后几分钟内发生。使用 exenatide 后，所有五名患者的排便频率和形态立即得到改善；排便不再与进食相关。三名患者成功停用全胃肠外营养。胃十二指肠测压显示空腹时持续出现低振幅胃收缩，而 exenatide 可完全使这些收缩正常化。
Exenatide 是 SBS 的一种新颖且安全的治疗选择。它显著改善了 SBS 患者的肠道习惯、营养状况和生活质量。成功用 exenatide 治疗可能会显著减少对全胃肠外营养和小肠移植的需求。
