Синдром Золлингера–Эллисона: современные аспекты диагностики и лечения

Цель обзора. Отразить современные представления о клинике, диагностике и лечении синдрома Золлингера–Эллисона (СЗЭ).

Основные положения. СЗЭ относится к редким заболеваниям, сопряженным с состоянием внутрижелудочной гиперацидности. Явление гиперацидности в рамках СЗЭ обусловлено гипергастринемией, ассоциированной с эктопической продукцией гастрина гастрин-продуцирующей опухолью — гастриномой. Заболевание нередко развивается у пациентов с синдромом множественной эндокринной неоплазии 1-го типа. Клиническая картина СЗЭ представляет прямое отражение гиперсекреции соляной кислоты с формированием эрозивноязвенных поражений пищевода, желудка и двенадцатиперстной кишки, резистентных к терапии стандартными дозами ингибиторов протонной помпы (ИПП). Одними из базисных методов диагностики СЗЭ являются определение уровня сывороточного гастрина и изучение состояния внутрижелудочного кислотообразования. Консервативная терапия включает назначение высоких доз ИПП, а также аналогов октреотида.

Заключение. Несмотря на то, что СЗЭ не относится к широко распространенным заболеваниям, знание о клиническом течении этой патологии важно для ее своевременного распознавания. Необходимо включение СЗЭ в круг дифференциальной диагностики у пациентов с часто рецидивирующими и резистентными к терапии стандартными дозами ИПП эрозивно-язвенными поражениями верхних отделов желудочно-кишечного тракта.

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