Sanchez R E, Longmire W P, Passaro E
Calif Med. 1972 Jun;116(6):1-7.
Thirteen cases of patients with the Zollinger-Ellison syndrome were reviewed. In two cases the diagnosis was made by incidental biopsy of small liver nodules at operation for peptic ulcer disease. Seven patients had gastric secretory tests which showed a basal acid output to maximum acid output ratio of more than 65 percent. Five patients had bao:mao ratios less than 50 percent.A 30-month interval between incidental discovery of tumor and clinically evident disease was observed in two patients. Recurrence of symptoms after excision of tumor was noted after a similar interval in another case. Serum gastrin levels, before total gastrectomy, were elevated in all cases. The lowest preoperative level in this series of patients was 550 picograms per ml (normal 100 to 150 picograms). They were diagnostic in two patients with normal gastric secretory studies. The levels fell to normal following total gastrectomy in six patients. Two patients still had elevated levels five years and 14 years after total gastrectomy. One was discovered to have a parathyroid adenoma with hypercalcemia. Total gastrectomy was curative in all the patients with the Zollinger-Ellison syndrome; lesser operations were not.
回顾了13例卓-艾综合征患者的情况。其中2例是在因消化性溃疡病手术时偶然对肝脏小结节进行活检而确诊的。7例患者进行了胃分泌功能测试，结果显示基础胃酸分泌量与最大胃酸分泌量之比超过65%。5例患者的该比值低于50%。2例患者在偶然发现肿瘤与出现临床明显疾病之间间隔了30个月。另一例在肿瘤切除后经过类似间隔期出现了症状复发。所有病例在全胃切除术前血清胃泌素水平均升高。该系列患者术前最低水平为每毫升550皮克（正常为100至150皮克）。在2例胃分泌功能研究正常的患者中，该水平具有诊断意义。6例患者在全胃切除术后水平降至正常。2例患者在全胃切除术后5年和14年时仍有升高。其中1例被发现患有甲状旁腺腺瘤并伴有高钙血症。全胃切除术对所有卓-艾综合征患者均有治愈效果；而较小的手术则不然。
