胃酸抑制后卓-艾综合征患者体重增加

Weight Gain in Zollinger-Ellison Syndrome After Acid Suppression.

作者信息

Riff Brian P, Leiman David A, Bennett Bonita, Fraker Douglas L, Metz David C

机构信息

From the *Division of Gastroenterology and †Department of Surgery, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

出版信息

Pancreas. 2016 Feb;45(2):193-7. doi: 10.1097/MPA.0000000000000376.

DOI:10.1097/MPA.0000000000000376

PMID:26164604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4706510/

Abstract

OBJECTIVES

Zollinger-Ellison syndrome (ZES) is characterized by hypergastrinemia and gastric acid hypersecretion resulting in peptic ulcer disease, diarrhea, and weight loss. Acid secretion can be controlled with medication, and biochemical cure is possible with surgery. Data on how these interventions affect patients' weight are lacking. We aimed to determine how medical and surgical acid control affects weight over time.

METHODS

We performed a retrospective cohort study on 60 ZES patients. Acid control was achieved with appropriate-dose proton pump inhibitor (PPI) therapy. Surgery was performed for curative intent when appropriate. Weight change was assessed versus pre-acid control or immediate preoperative weights and expressed as absolute and percent change from baseline at 6, 12, 18, and 24 months.

RESULTS

A total of 30 PPI-controlled patients and 20 surgery-controlled patients were analyzed. Weight gain was noted at all time points while on appropriate-dose PPI therapy (P < 0.005). Of patients who had surgery with curative intent, weight gain was noted at 12 months (7.9%, P = 0.013) and 18 months (7.1%, P = 0.007). There was a trend toward weight gain seen at all time points in the patients who were surgically cured.

CONCLUSIONS

These data represent a novel description of weight gain after acid suppression in ZES.

摘要

目的

卓-艾综合征（ZES）的特征为高胃泌素血症和胃酸分泌过多，导致消化性溃疡病、腹泻及体重减轻。酸分泌可用药物控制，手术有可能实现生化治愈。目前缺乏关于这些干预措施如何影响患者体重的数据。我们旨在确定药物和手术控制胃酸对体重随时间的影响。

方法

我们对60例ZES患者进行了一项回顾性队列研究。通过适当剂量的质子泵抑制剂（PPI）治疗实现酸控制。在适当的时候进行手术以达到治愈目的。将体重变化与酸控制前或术前即刻体重进行比较，并表示为6、12、18和24个月时相对于基线的绝对变化和百分比变化。

结果

共分析了30例接受PPI控制的患者和20例接受手术控制的患者。在接受适当剂量PPI治疗的所有时间点均观察到体重增加（P<0.005）。接受治愈性手术的患者在12个月时体重增加（7.9%，P=0.013），在18个月时体重增加（7.1%，P=0.007）。手术治愈的患者在所有时间点均有体重增加的趋势。