tory burch outlet Gastrinoma of the principles of

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Gastrinoma of the principles of drug treatment


Objective To investigate the principles of drug therapy gastrinoma, analysis of different stages of treatment of drug selection and application of principles. Research our department from 2006 to 2009 for treatment of gastrinoma information, follow-up survey of patients with drug efficacy. Conclusion According to the medical condition of patients given different doses of drugs and drug treatment.
gastrinoma gastrinoma
principles of drug therapy is a function of the tumor with the secretion of gastrin and its clinical manifestations of gastric juice, gastric acid hypersecretion, hypergastrinemia, multiple, non- Typical parts of refractory peptic ulcer, diarrhea syndrome group. The syndrome group and ellison by the zollinger first reported in 1955, this sign may be a tumor or antral gastrin secretion g cell hyperplasia. Caused by the former is called zollinger-ellison syndrome? Type, is caused by the latter as i type. About 20% of gastrinoma patients can be expressed as multiple endocrine neoplasia syndrome type i, or i-type multiple endocrine neoplasia. Peptic ulcer, caused by the disease were less than 1%. Can occur at any age, but the more common 35 to 65 years. Men slightly more than women. Although the majority of malignant gastrinoma, but the tumor is small, slow development, so the tumor itself rarely causes obvious symptoms, the disease advanced, invasive cancer symptoms appear side. The clinical manifestations and a large number of gastric acid secretion. Once gastrinoma resection, the disease has been cured. Malignant gastrinoma of its low degree of malignancy, slow growth, although with larger tumor or metastasis elsewhere, patients can still live a normal life for many years. According to reports, 5 to 10-year survival rate of 30% to 40%. Somatostatin receptor scintigraphy and endoscopic ultrasound can help gastrinoma location. Leading cause of death was cancer metastasis,ghd planchas, followed by peptic ulcer complications and severe diarrhea caused by water and electrolyte imbalance. Surgical tumor resection, total gastrectomy, highly selective gastric vagotomy surgery and removal of other endocrine tumors.
A related drugs
1.h2 receptor blockers
include cimetidine, famotidine, ranitidine, and use the mechanism described in section peptic ulcer.
2.
including proton pump inhibitors omeprazole, lansoprazole, pantoprazole, and use the mechanism described in section peptic ulcer.

3. somatostatin and somatostatin analogues
include; octreotide; lanreotide, somatostatin 14 for the synthetic peptide somatostatin, its half-life of only 1.1 ~ 3min, octreotide is 8 peptide somatostatin analogues, half-life of 180min. Both have a strong inhibition of gastric acid and pancreatic secretion, stimulate mucous secretion and reduce portal pressure, both expensive, and are intravenous formulations, limiting long-term clinical application. Lanreotide slow-release particulate preparation of octreotide,tory burch outlet, elimination half-life after intramuscular injection of 4.5 days, the role of sustainable 10 to 15 days. Octreotide long-acting somatostatin may change the application of drugs in the treatment of gastrinoma in the position. 4.
Chemotherapy including streptozocin ,5-fu,tory burch outlet, doxorubicin, interferon-α, dacarbazine. Mainly used for the treatment of metastatic gastrinoma, the vast majority of information is limited to case reports,abercrombie ireland, limited efficacy.
Second, the principle of selection
1. The fundamental treatment of this disease is to remove the tumors produce gastrin. Can not be found on the tumor and the tumor can not be completely removed by drug treatment.
2. histamine h2 receptor antagonist, anticholinergic drugs can be combined synergistic effect. Proton pump inhibitors, can strongly inhibit gastric acid secretion caused by various stimuli, is the most effective drug treatment of this disease, the amount of acid drugs should be people vary, the general idea basal acid secretion <10meq / h, gastric Department of resection is bao <5meq / h, sufficient doses of drug therapy is the standard. Resection of the tumor can not, acid drugs for long-term maintenance therapy, or prone to peptic ulcer complications.
3. chemotherapy for advanced cancer and had metastasis. Streptozocin combined 5-fu good effect. Advocates from the abdominal artery intervention, may decrease the risk of adverse reactions and increase efficacy.
Third, note
1.h2ra
Cimetidine: tablets; sustained-release tablets ranitidine
:
Famotidine tablets: tablets / capsules
Usage: Each cimetidine 300mg, 4 times a day, orally, as needed to adjust to 2400mg / d. Each ranitidine 150mg, 4 times a day orally, adjusted to 6g / d. Famotidine each 20mg, four times a day, orally, as needed to adjust 160mg / d. Long-term use of these drugs will be gradually reduced efficiency or failure, with the emergence of ppi drugs, application of these drugs are less and less.
References
1 high Yunfu; Dingqi Fan; diameter and handsome; Aozhi new; Lizhong Fang; Mao-guide;; gastrinoma case report j; Jiangxi Medicine; 1980 01
2 Renjun Long; Jiabo Qi;; antral gastrin and its clinical significance j; International Gastroenterology; 1983 04
3 Zhu Zuguang; Yuda Hong; Ye Zhicheng;; zollinger-ellison syndrome j; International Gastroenterology; 1983 04
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