Sirinek K R, O'Dorisio T M, Howe B, McFee A S
Arch Surg. 1985 May;120(5):605-9. doi: 10.1001/archsurg.1985.01390290083014.
This study evaluated the effect of gastric bypass on the glucose, insulin, vasoactive intestinal peptide (VIP), neurotensin, and motilin response to orally administered glucose in eight morbidly obese patients before and after operation. Preoperatively, all eight patients remained asymptomatic during an oral glucose tolerance test, which showed glucose intolerance and hyperinsulinism. Plasma VIP, neurotensin, and motilin remained below detectable levels for the entire test. At three months following gastric bypass (21% weight loss), all eight patients became acutely ill during a repeated oral glucose tolerance test and had the following symptoms: facial flushing (eight patients), palpitations (eight patients), nausea (seven patients), abdominal fullness (seven patients), pallor (four patients), diaphoresis (two patients), vomiting (two patients), and diarrhea (two patients). Significant release of neurotensin occurred in seven patients while three patients had release of VIP, further implicating these two peptides as part of the pathophysiologic spectrum of the "dumping syndrome."
本研究评估了胃旁路手术对8例病态肥胖患者术前及术后口服葡萄糖后血糖、胰岛素、血管活性肠肽（VIP）、神经降压素和胃动素反应的影响。术前，所有8例患者在口服葡萄糖耐量试验期间均无症状，该试验显示存在葡萄糖不耐受和高胰岛素血症。在整个试验过程中，血浆VIP、神经降压素和胃动素水平均低于可检测水平。胃旁路手术后三个月（体重减轻21%），所有8例患者在重复口服葡萄糖耐量试验期间均突发不适，并出现以下症状：面部潮红（8例）、心悸（8例）、恶心（7例）、腹部饱胀感（7例）、面色苍白（4例）、出汗（2例）、呕吐（2例）和腹泻（2例）。7例患者出现神经降压素显著释放，3例患者出现VIP释放，进一步表明这两种肽是“倾倒综合征”病理生理谱的一部分。
