Gianetta E, Bloom S R, Sarson D L, Civalleri D, Bonalumi U, Griffanti Bartoli F, Friedman D, Pitton L, Binda P L, Degrandi R, Scopinaro N
Boll Soc Ital Biol Sper. 1980 Oct 15;56(19):1915-21.
Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis place 50 cm proximal to the ileocecal valve. Neurotensin and enteroglucagon fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 11 subjects within two months, in 12 subjects four to twelve months and in 7 subjects fifteen to twenty months after operation. Basal plasma enteroglucagon was significantly higher in the obese group than in the controls. However, there was no difference in the peak response, and a decrease, though not statistically significant, was seen in the integrated response. All three values were strikingly augmented in the 0-2 month group, with a highly significant difference from the preoperative group. The 4-12 and 15-20 month groups, in comparison with the 0-2 month group, showed no changes in fasting levels, a clear-cut decreased peak response and a sharp progressive reduction in integrated response, mean value in the 15-20 month group being significantly lower than that of 0-2 month group. Neurotensin basal and meal-stimulated peak plasma concentrations in the obese group were significantly higher than in the control group, whilst the integrated response was almost identical in the two groups. In postoperative groups no substantial changes in fasting levels and an increase in the peak response were observed, with a considerable progressive rise in the integrated response.
肥胖症的胆胰分流术包括三分之二的远端胃切除术及Roux-en-Y重建术，即小肠在中点处横断，肠肠吻合术在回盲瓣近端50厘米处进行。对13名非肥胖健康志愿者、13名未接受手术的肥胖患者、11名术后两个月内的受试者、12名术后四至十二个月的受试者以及7名术后十五至二十个月的受试者，测定了神经降压素和肠高血糖素空腹及进食刺激后的血浆浓度。肥胖组的基础血浆肠高血糖素显著高于对照组。然而，峰值反应无差异，综合反应虽无统计学意义但有所下降。所有这三个值在0至2个月组中均显著升高，与术前组有高度显著差异。与0至2个月组相比，4至12个月组和15至20个月组的空腹水平无变化，峰值反应明显下降，综合反应急剧逐渐降低，15至20个月组的平均值显著低于0至2个月组。肥胖组的神经降压素基础血浆浓度和进食刺激后的峰值血浆浓度显著高于对照组，而两组的综合反应几乎相同。在术后各组中，空腹水平无实质性变化，峰值反应增加，综合反应有相当大的逐渐上升。
