protein depletion gastrointestinal syndrome
Introduction
Introduction to protein loss gastrointestinal syndrome Proteinlosing gastroenteropathy syndrome (also known as proteinlosing gastroenteropathy) is also known as protein leakage gastrointestinal disease or exudative gastrointestinal disease, which refers to plasma proteins caused by various reasons, especially A syndrome caused by the loss of albumin from the gastrointestinal mucosa. Clinically, it mainly manifests as systemic edema and low plasma proteinemia. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: multiple lung infections Functional dyspepsia
Cause
Protein loss of gastrointestinal syndrome
Gastrointestinal mucosal epithelial abnormalities (30%):
Such as hypertrophic gastritis, gastric cancer, ulcerative colitis, localized enteritis, Crohn's disease, intestinal cancer or any other inflammation and ulcer lesions, can penetrate the intestinal mucosa from the mucosa of the lesion, such as when the liver is more compensatory That forms hypoproteinemia.
Gastrointestinal or systemic lymphatic abnormalities (25%):
There are lymphatic obstruction of the thoracic duct, constrictive pericarditis, congestive heart failure, poor intestinal lymphatic drainage, small bowel lymphatic dilatation, etc., hypoproteinemia of constrictive pericarditis and congestive heart failure, mainly Because the increase of central venous pressure hinders the reflux of the lymphatic vessels in the thoracic duct, which causes the loss of intestinal protein. The small bowel lymphatic distension may be a congenital defect. After the ruptured lymphatic vessels are ruptured, the plasma protein and Lymphocytes are lost from the intestines.
Disease with increased capillary permeability (25%):
For example, colonic polyposis with telangiectasia, allergic gastro-intestinal disease, gastrointestinal mucosal metabolic disorders, etc., have increased capillary permeability, resulting in protein loss, typically such as adult celiac disease.
Hypoproteinemia can have four pathophysiological changes: 1 reduced acquired protein synthesis; 2 reduced congenital protein synthesis; 3 increased protein catabolism; 4 loss of excess protein from urine and feces.
Prevention
Protein loss prevention of gastrointestinal syndrome
Pay attention to the prevention and timely treatment of some diseases causing the disease, such as gastrointestinal inflammation and other diseases, pay attention to prevention of protein loss and hypoproteinemia.
Complication
Protein loss complications of gastrointestinal syndrome Complications multiple lung infection functional dyspepsia
1. Lung infection.
2, hand and foot squatting.
3. Reduced immunity.
4, water, electrolyte metabolism disorders.
Symptom
Protein loss of gastrointestinal syndrome symptoms common symptoms diarrhea ascites systemic persistent edema hypoproteinemia nausea abdominal pain
Due to the loss of plasma protein, especially albumin, causing a decrease in colloid osmotic pressure and an increase in secondary aldosterone, resulting in retention of sodium and water, patients may have systemic edema, especially in lower limbs, in addition to pleural effusion, ascites, and weight loss. Anemia, etc., children may have developmental disorders, gastrointestinal symptoms may have loss of appetite, nausea, vomiting, diarrhea and abdominal pain, calcium loss can induce hand and foot spasm, intestinal lymphangiectasis often have immunoglobulin loss and cellular immune abnormalities The lymphocyte ancestor of phytohemagglutinin is also weakened, so it is prone to pulmonary infection.
Examine
Protein loss test for gastrointestinal syndrome
(a) 131I-PVP:
PVP (polyvinylpyrrolidone) is a macromolecular substance that is rarely absorbed in the digestive tract. After intravenous injection of 10 to 15 microcuries, 4 days of urine containing no urine is collected for measurement: normal people only excrete 0%~ 1.5%, the excretion of patients with this disease can increase by 2.9% to 32.5%. In recent years, 59Fe-dextran has been used instead of 131I-PVP.
(B) 51Crr-albumin and 51Crr-transferrin:
Intravenous injection of 25 microcurie 51Crr albumin, collecting 4 days of urine-free feces, normal excretion is 0.1% to 0.7%, and patients with this disease excretion 2% to 40%, recently reported that intravenous injection of 10 micro Curie 51Crr-transferrin is more effective, because the labeled albumin or transferrin is hardly absorbed from the gastrointestinal tract and is not secreted from normal digestive juices (such as saliva, gastric juice). The amount of intestinal protein lost is very valuable. Since 51Crr can be excreted from the urine, it must not be mixed with the urine when collecting stool samples.
In addition, X-ray gastrointestinal barium meal examination and lymphangiography, endoscopy, etc. can be done to help diagnose.
Diagnosis
Diagnosis and differentiation of protein loss gastrointestinal syndrome
According to clinical manifestations, especially systemic edema with hypoproteinemia, the disease should be considered, and then combined with laboratory tests to diagnose.
