Tazuke Yuko, Kimura Takeshi, Ueno Takehisa, Nakahata Kengo, Deguchi Koichi, Uga Naoko, Okuyama Hiroomi, Oue Takaharu
Department of Pediatric Surgery, Hyogo Medical University, Mukogawa-Cho, Nishinomiya, Hyogo, 663-8501, Japan.
Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan.
Pediatr Surg Int. 2025 Aug 28;41(1):273. doi: 10.1007/s00383-025-06154-z.
To evaluate the impact of three-year Glucagon-like peptide 2 (GLP-2) analog therapy on parenteral nutrition (PN) dependency, intestinal rehabilitation, and quality of life in pediatric-onset short bowel syndrome (SBS).
Between August 2021 and December 2024, 18 pediatric-onset SBS patients underwent GLP-2-based intestinal rehabilitation. The remaining length of the small intestine ranged from 20 to 50 cm in adults and averaged 20 cm in children. Clinical data were retrospectively analyzed over a three-year period.
PN requirements in adults decreased by up to 54.6%, with one patient achieving PN independence. Paediatric patients showed gradual reductions of up to 31.9%. Serum citrulline levels improved, suggesting enhanced intestinal adaptation. Stool consistency improved in all patients, and stool frequency decreased in six patients. PN duration per week decreased in eight patients, with one paediatric patient successfully being weaned off PN. All patients maintained social participation, though six children required special educational support due to ongoing PN use. No intestinal polyps were detected, and any adverse events were mild and self-limiting.
GLP-2 analog therapy, which is based on intestinal rehabilitation, contributed to a sustained reduction in PN and enhanced clinical outcomes over three years, particularly in adult SBS patients. Continuous GLP-2 analog therapy might improve quality of life in paediatric-onset SBS.
评估三年期胰高血糖素样肽2（GLP-2）类似物疗法对儿童期短肠综合征（SBS）患者肠外营养（PN）依赖、肠道康复及生活质量的影响。
2021年8月至2024年12月期间，18例儿童期SBS患者接受了基于GLP-2的肠道康复治疗。成人小肠剩余长度为20至50厘米，儿童平均为20厘米。对三年期间的临床数据进行回顾性分析。
成人的PN需求最多降低了54.6%，有1例患者实现了PN独立。儿科患者的需求逐渐降低，最多降低了31.9%。血清瓜氨酸水平有所改善，表明肠道适应性增强。所有患者的粪便稠度均有改善，6例患者的排便频率降低。8例患者每周的PN持续时间减少，1例儿科患者成功停用PN。所有患者均保持社会参与度，不过6名儿童因持续使用PN而需要特殊教育支持。未检测到肠息肉，且所有不良事件均较轻微且为自限性。
基于肠道康复的GLP-2类似物疗法有助于在三年时间里持续减少PN并改善临床结局，尤其是在成人SBS患者中。持续的GLP-2类似物疗法可能会改善儿童期SBS患者的生活质量。
