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手术干预后早期应用利拉鲁肽对短肠综合征患者临床结局的影响:一项前瞻性“真实世界”研究。

Effects of Treatment with Liraglutide Early after Surgical Intervention on Clinical Outcomes in Patients with Short Bowel Syndrome: A Pilot Observational "Real-Life" Study.

机构信息

Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy.

Department of Medical Science, University of Torino, C.so Dogliotti 14, 10126 Torino, Italy.

出版信息

Nutrients. 2023 Jun 14;15(12):2740. doi: 10.3390/nu15122740.

Abstract

Liraglutide, a glucagon-like peptide-1 agonist, has been shown to have beneficial effects on fecal output in short bowel syndrome (SBS) by small human studies. Its potential effects early after gut resection are not known. In this pilot observational study, we described the 1- and 6-month liraglutide effects in 19 adult patients with a new SBS diagnosis within 1 month after surgical resection. Stomal/fecal and urinary outcomes, serum/urinary electrolytes, and body composition were assessed. Both within-group differences and between-group comparisons with 20 SBS patients refusing liraglutide treatment were evaluated. The main liraglutide-related side effect was mild nausea, except in one patient, who experienced severe nausea/vomiting. The median ostomy/fecal output was significantly reduced by -550 mL/day after 6 months of treatment (. -200 mL/day in untreated, = 0.04). The number of patients reaching a ≥20% output reduction was 10/19 (52.6%) treated . 3/20 (15.0%) untreated patients ( = 0.013) at 1 month and 12/19 (63.2%) . 6/20 (30.0%) ( = 0.038) at 6 months, respectively. Participants with a clinically relevant output reduction at 6 months had a significantly lower baseline weight and BMI. Energy parenteral supply significantly decreased, while infused volumes, oral energy, and fluid intakes slightly decreased, though not significantly. This pilot study supports liraglutide benefits in ostomy/fecal output early after surgical gut resection in SBS patients, particularly in those with lower baseline weight values.

摘要

利拉鲁肽是一种胰高血糖素样肽-1 激动剂,小型人体研究表明其对短肠综合征(SBS)的粪便排出量有有益影响。但其在肠道切除术后早期的潜在作用尚不清楚。在这项初步观察性研究中,我们描述了 19 名新诊断为 SBS 的成年患者在手术后 1 个月内使用利拉鲁肽的 1 个月和 6 个月的效果。评估了造口/粪便和尿液结局、血清/尿液电解质以及身体成分。评估了组内差异和与拒绝利拉鲁肽治疗的 20 名 SBS 患者的组间比较。主要的利拉鲁肽相关副作用是轻度恶心,除了 1 名患者出现严重恶心/呕吐。治疗 6 个月后,造口/粪便量中位数减少了-550 毫升/天(未治疗时减少-200 毫升/天, = 0.04)。在治疗组中,有 10/19(52.6%)名患者达到了粪便排出量减少≥20%,而未治疗组中仅有 3/20(15.0%)( = 0.013)。治疗组中有 12/19(63.2%)在 1 个月时达到了,而 6/20(30.0%)在 6 个月时达到了( = 0.038)。在 6 个月时粪便排出量有临床意义减少的患者,其基线体重和 BMI 显著更低。肠外能量供应显著减少,而输注量、口服能量和液体摄入略有减少,但无统计学意义。这项初步研究支持利拉鲁肽在 SBS 患者肠道切除术后早期对造口/粪便排出量的有益作用,尤其是在基线体重值较低的患者中。

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