Yeaton P, Frierson H F
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville.
Am J Gastroenterol. 1993 Jan;88(1):95-8.
A 47-yr-old man with Ménétrier's disease presented with profound enteral protein losses documented by 51Cr-albumin stool studies. There was no response to anticholinergics, H2-receptor antagonists, or proton pump inhibition. Subcutaneous octreotide acetate, 100 micrograms bid, resulted in clinical improvement with rapid resolution of enteral protein losses. Octreotide was continued for 12 months. During an additional 5-month follow-up period without therapy, the patient remained improved clinically with low to normal serum proteins, despite the persistence of gastric rugal hypertrophy. The evidence that octreotide resolved enteral protein losses and eliminated the need for urgent gastrectomy in our patient warrants a trial of this drug for other patients with Ménétrier's disease.
一名47岁患有梅内特里尔病的男性患者,经51铬白蛋白粪便研究证实存在严重的肠内蛋白质丢失。对抗胆碱能药物、H2受体拮抗剂或质子泵抑制剂均无反应。皮下注射醋酸奥曲肽,每日两次,每次100微克,临床症状改善,肠内蛋白质丢失迅速得到缓解。奥曲肽持续使用12个月。在随后5个月未接受治疗的随访期间,尽管胃皱襞肥大持续存在,但患者临床症状仍持续改善,血清蛋白水平低至正常。奥曲肽解决了我们这位患者的肠内蛋白质丢失问题,并消除了紧急胃切除术的必要性,这一证据表明应对其他梅内特里尔病患者试用这种药物。