The clinical diagnosis of the Zollinger-Ellison syndrome.
The clinical diagnosis of the Zollinger-Ellison syndrome.
复制标题
佐林格-埃利森综合征的临床诊断。
DOI：
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发表时间：
1979
期刊：
影响因子：
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通讯作者：
F. Stadil
中科院分区：
文献类型：
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作者：
J. Stage;F. Stadil
最近 34 名 Z-E 患者的临床经验表明，该综合征的临床特征和病程没有最初描述的那么严重。 85% 的患者讲述了持续五年以上的腹部主诉，与十二指肠溃疡患者 (DU) 的主诉类似。 91%的患者存在溃疡。百分之五十一患有异位或多发性溃疡。三分之一的人患有类似于普通溃疡的单一十二指肠溃疡。没有患者死于溃疡素质并发症。 ZE 组中存在明显的胃酸和胃泌素分泌过多（BAO：33.7 +/- 7.4；PAO：62.8 +/- 6.1 meq H+/h；胃泌素：5094 pmol/l），但由于 ZE 的个体差异很大，因此可以看到与 DU 的胃酸和胃泌素测量值有一些重叠。使用促胰液素、钙、胰高血糖素和食物刺激进行的激发试验的诊断价值表明，两组之间有相当大的重叠，表明这些试验的临床价值不大。一半患者发现肿瘤，其中十人发现恶性肿瘤。在大多数情况下，可以通过结合症状学以及酸和胃泌素的测量来诊断 ZE。
Recent clinical experiences with 34 Z-E patients indicates that the clinical features and course of the syndrome is less dramatic than described originally. Eighty-five per cent of the patients presented stories of abdominal complaints lasting more than five years and resembling the complaints presented by duodenal ulcer patients (DU). Ulcers were present in 91 per cent of the patients. Fifty-one per cent had either ectopic or multiple ulcers. One third had a single duodenal ulcer resembling an ordinary ulcer. No patients died from complications to the ulcer diathesis. Marked hypersecretion of acid and gastrin was present in the ZE group (BAO:33.7 +/- 7.4; PAO:62.8 +/- 6.1 meq H+/h; gastrin: 5094 pmol/l), but because of great individual variation in the ZE, some overlapping with the acid and gastrin measurements of the DU was seen. The diagnostic value of provocative tests using secretin, calcium, glucagon and food stimulations demonstrated a considerable overlapping between the two groups, indicating that these tests are of little clinical value. Tumours were found in half the patients, revealing malignancy in ten. The ZE can be diagnosed in most cases by combining symptomatology, with measurements of acid and gastrin.