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贝那鲁肽治疗胃切除术后迟发性倾倒综合征患者的疗效:一例报告。

Effectiveness of beinaglutide in a patient with late dumping syndrome after gastrectomy: A case report.

机构信息

Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China.

出版信息

Medicine (Baltimore). 2021 May 28;100(21):e26086. doi: 10.1097/MD.0000000000026086.

Abstract

RATIONALE

Dumping syndrome is a frequent and potentially severe complication after gastric surgery. Beinaglutide, a recombinant human glucagon-like peptide-1 (GLP-1) which shares 100% homology with human GLP-1(7-36), has never been reported in the treatment of dumping syndrome before.

PATIENT CONCERNS

The patient had undergone distal gastrectomy for gastric signet ring cell carcinoma 16 months ago. He presented with symptoms of paroxysmal palpitation, sweating, and dizziness for 4 months.

DIAGNOSIS

He was diagnosed with late dumping syndrome.

INTERVENTIONS AND OUTCOMES

The patient was treated with dietary changes and acarbose for 4 months before admitted to our hospital. The treatment with dietary changes and acarbose did not prevent postprandial hyperinsulinemia and hypoglycemia according to the 75 g oral glucose tolerance test (OGTT) and continuous glucose monitoring (CGM) on admission.Therefore, the patient was treated with beinaglutide 0.1 mg before breakfast and lunch instead of acarbose. After the treatment of beinaglutide for 1 month, OGTT showed a reduction in postprandial hyperinsulinemia compared with before starting treatment, and the time in the range of 3.9 to 10 mmol/L became 100% in CGM. No side effect was observed in this patient during beinaglutide treatment.

LESSONS

These findings suggest that beinaglutide may be effective for treating post-gastrectomy late dumping syndrome.

摘要

背景

倾倒综合征是胃手术后常见且潜在严重的并发症。贝那鲁肽,一种与人类 GLP-1(7-36)具有 100%同源性的重组人胰高血糖素样肽-1(GLP-1),以前从未用于治疗倾倒综合征。

患者情况

该患者 16 个月前因胃印戒细胞癌行远端胃切除术,4 个月来出现阵发性心悸、出汗和头晕。

诊断

诊断为迟发性倾倒综合征。

干预措施和结果

该患者在入院前接受了饮食改变和阿卡波糖治疗 4 个月。根据入院时的 75g 口服葡萄糖耐量试验(OGTT)和连续血糖监测(CGM),饮食改变和阿卡波糖治疗未能预防餐后高胰岛素血症和低血糖。因此,该患者改用贝那鲁肽 0.1mg,每日早餐和午餐前注射,而非阿卡波糖。贝那鲁肽治疗 1 个月后,OGTT 显示与治疗前相比,餐后高胰岛素血症减少,CGM 中 3.9 至 10mmol/L 的时间达到 100%。在贝那鲁肽治疗期间,该患者未观察到任何不良反应。

结论

这些发现表明,贝那鲁肽可能对治疗胃切除术后迟发性倾倒综合征有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b7d/8154494/dd62940fadaa/medi-100-e26086-g001.jpg

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