Assessment of the upper gastrointestinal tract in hemodialysis patients awaiting renal transplantation.
Assessment of the upper gastrointestinal tract in hemodialysis patients awaiting renal transplantation.
复制标题
等待肾移植的血液透析患者的上消化道评估。
DOI：
--
复制
发表时间：
1983
影响因子：
9.8
通讯作者：
Casciani Cu
中科院分区：
文献类型：
--
作者：
G. Milito;M. Taccone;C. Brancaleone;F. Nardi;Filingeri;D. Cesca;Casciani Cu
对75例等待肾移植的透析患者进行了研究。检查包括单对比钡餐，血清胃泌素测定，胃酸检查，纤维胃镜检查和多次活检。放射学检查发现5例十二指肠溃疡和1例胃溃疡。胃镜检查显示胃十二指肠病变57例(49%)。浅表性胃炎50例(66.7%)，萎缩性胃炎11例(14.6%)，十二指肠炎30例(40%)。高胃泌素血症48例(%)。33例患者最大胃酸排出量明显升高。胃酸高分泌与胃镜下病变的存在和胃炎的组织学证据相关。11例萎缩性胃炎中有9例胃酸过低，胃泌素水平较低。移植前的胃评估确定了这些患者中相关数量的胃十二指肠病变。移植后严重溃疡风险的增加证明了所有肾移植候选患者进行彻底的胃部评估和预防性抗溃疡治疗是合理的。
Seventy-five dialysis patients awaiting renal transplantation were studied. Investigations included single contrast barium meal, serum gastrin assay, gastric acid studies, and fiberoptic gastroduodenoscopy with multiple biopsies. Radiological studies revealed five duodenal ulcers and one gastric ulcer. Endoscopy showed gastroduodenal lesions in 57 patients (49%). Superficial gastritis was present in 50 patients (66.7%), atrophic gastritis in 11 (14.6%), and duodenitis in 30 (40%). Hypergastrinemia was observed in 48 patients (64%). Maximum acid output was markedly elevated in 33 patients. Acid hypersecretion was found to be correlated with the presence of endoscopic lesions and histological evidence of gastritis. Nine of the 11 patients with atrophic gastritis were acid hyposecretors and had low gastrin levels. Pretransplant gastric assessment identified a relevant number of gastroduodenal lesions in these patients. The increased risk of severe posttransplant ulceration justifies thorough gastric assessment and prophylactic antiulcer therapy in all renal transplant candidates.