Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage:A prospective case control study  

作　　者：Tajana Pavic Stipe Pelajic Nina Blazevic Dominik Kralj Milan Milosevic Ivana Mikolasevic Ivan Lerotic Davor Hrabar 

机构地区：[1]Department of Gastroenterology and Hepatology,University Hospital Center Sestre Milosrdnice,Zagreb 10000,Croatia [2]Andrija Stampar School of Public Health WHO Collaborative Centre for Occupational Health,University of Zagreb,School of Medicine,Zagreb 10000,Croatia [3]Department of Gastroenterology,University Hospital Center Rijeka,Rijeka 51000,Croatia

出　　处：《World Journal of Clinical Cases》2022年第17期5551-5565,共15页世界临床病例杂志

摘　　要：BACKGROUND Biliary obstruction is a relatively common condition that affects approximately 5 in 1000 people annually.Malnutrition is very common in patients with biliary obstruction and since it is associated with significant morbidity and mortality,it is important to identify factors and mechanisms involved in its development.AIM To determine the influence of obstructive jaundice on the hormones controlling appetite and nutritive status.METHODS This was a prospective case control study performed in a tertiary center in Zagreb,Croatia.Patients with biliary obstruction undergoing internal biliary drainage from September 2012 until August 2013 were enrolled.After excluding patients who developed procedure related complications or were lost in the follow-up,out of initial 73 patients,55 patients were included in the analysis,including 34 with benign and 21 with malignant disease.Meanwhile,40 non-jaundiced controls were also included.Appetite,nutritional status,and serum ghrelin,cholecystokinin(CCK),interleukin 6(IL-6),and tumor necrosis factorα(TNF-α)were determined at admission,48 h and 28 d after internal biliary drainage.Chi square test was used for categorical variables.Continuous variables were analysed for normality by Kolmogorov-Smirnov test and relevant non-parametric(Mann-Whitney,Kruskal-Wallis,and Friedman)or parametric(t-test and analysis of variance)tests were used.RESULTS Patients with obstructive jaundice were significantly malnourished compared to controls,regardless of disease etiology.Plasma ghrelin and CCK levels were significantly higher in patients with obstructive jaundice.Serum bilirubin concentrations were negatively correlated with ghrelin levels and positively correlated with TNF-α,but had no correlation with CCK concentrations.After internal biliary drainage,a significant improvement of nutritional status was observed although serum concentrations of ghrelin,IL-6,and TNF-α remained significantly elevated even 28 d after the procedure.CCK levels in patients without malnutrition remained

关 键 词：GHRELIN CHOLECYSTOKININ Biliary obstruction MALNUTRITION 

分 类 号：R57[医药卫生—消化系统]