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生长抑素对胃手术后倾倒综合征的影响。

The effect of somatostatin in dumping syndrome after gastric surgery.

作者信息

Tulassay Z, Tulassay T, Gupta R, Tamás G

机构信息

First Department of Internal Medicine, Semmelweis University, Budapest, Hungary.

出版信息

Acta Gastroenterol Belg. 1993 Mar-Apr;56(2):219-22.

PMID:8103615
Abstract

The effect of somatostatin on early and late dumping syndrome was studied in 12 patients with gastric resection. Each patient underwent two glucose challenges with 75 gram of glucose administered orally. In the control study isotonic sodium chloride was given, while in the other study cyclic somatostatin in a dose of 80 ng/kg/min was given for a period of 270 minutes. In the control study all patients showed subjective symptoms of the early dumping syndrome with significant (p < 0.001) increases in pulse rate, hematocrit, and vasoactive intestinal polypeptide. Ten patients showed asymptomatic hypoglycemia, as a sign of the late dumping syndrome associated with a significant (p < 0.001) increase of insulin, gastric inhibitory peptide and glucagon levels. During the administration of somatostatin these changes failed to develop. The difference between the results of the two challenges are significant. These results indicate that somatostatin alleviates the symptoms both of early and late dumping syndrome partly by inhibiting the vasoactive intestinal polypeptide, gastric inhibitory peptide and insulin release, which are increased in dumping syndrome and may, therefore, be implicated as to have an etiological role.

摘要

在12例胃切除患者中研究了生长抑素对早期和晚期倾倒综合征的影响。每位患者接受两次口服75克葡萄糖的葡萄糖激发试验。在对照研究中给予等渗氯化钠,而在另一项研究中,以80 ng/kg/分钟的剂量给予环状生长抑素,持续270分钟。在对照研究中,所有患者均出现早期倾倒综合征的主观症状,脉搏率、血细胞比容和血管活性肠肽显著升高(p<0.001)。10例患者出现无症状低血糖,这是晚期倾倒综合征的一个迹象,同时胰岛素、胃抑制肽和胰高血糖素水平显著升高(p<0.001)。在生长抑素给药期间,这些变化未出现。两次激发试验结果之间的差异具有显著性。这些结果表明,生长抑素部分通过抑制血管活性肠肽、胃抑制肽和胰岛素释放来缓解早期和晚期倾倒综合征的症状,这些物质在倾倒综合征中升高,因此可能具有病因学作用。

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