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袖子到旁路转换与袖子与辅助GLP-1受体激动剂:一个学术多中心的回顾性研究
Avery Brown1,2, Helena Sergent3, Alexander Hien Vu4
1Department of General Surgery, Bellevue Hospital, 462 1St Ave, New York, NY, 10016, USA. avery.brown@nyulangone.org.
Surgical endoscopy
|July 21, 2025
概括
对于在袖子胃切除术后体重减轻不足的患者,转换为Roux-En-Y胃绕道 (cRYGB) 提供了比葡萄糖类-1受体激动剂 (GLP1-RAs) 更大的长期体重减轻. 与cRYGB相比,GLP1-RAs在HbA1c控制中没有显著差异.
科学领域:
- 腹部外科 腹部外科
- 内分泌学 在内分泌学.
- 代谢健康 代谢健康
背景情况:
- 类似葡萄糖-1受体激动剂 (GLP1-RAs) 正在成为袖子胃切除术后体重管理的替代品.
- 袖子胃切除术后体重减轻不足或复发的患者可以考虑GLP1-RAs或修复性手术.
研究的目的:
- 为了比较转换到Roux-En-Y胃绕道 (cRYGB) 与GLP1-RAs在袖子胃切除术后体重减轻不足的患者的疗效.
- 在接受修复性减肥手术或药物治疗的患者中评估长期减肥和血糖控制.
主要方法:
- 分析了先前进行过袖子胃切除术的成年患者 (≥18岁).
- 组包括那些接受每周注射的塞马格卢提德/蒂尔泽帕提德治疗的人或那些接受cRYGB的人.
- 排除标准包括转换为GERD,使用GLP1-RA,BMI≤35,或之前使用GLP1-RA.
主要成果:
- 分析了4901名患者 (3004名cRYGB,1897名GLP1-RA) 在干预前体重没有显著差异.
- 在cRYGB患者中,基线HbA1c较高 (6.19与5.85,p<0.001).
- 在长达3年的时间里,cRYGB的体重减轻显著增加 (26.1%与13.7%,p<0.001),HbA1c对照没有差异.
结论:
- 与GLP1-RAs相比,转换为cRYGB的结果是优越的长期体重减轻在袖子胃切除术后体重减轻不足的患者.
- 两种治疗都没有显示出两组之间血糖控制 (HbA1c) 的显著差异.
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