对长期用生长抑素激动剂治疗肢端肥大症停药后生长激素分泌和胆囊收缩功能的观察  

AN OBSERVATIONO OF THE SECRETION OF GROWTH HORMONE AND CONTRACTION OF GALL BLADDER AFTER LONG-TERM USE OF GROWTH-INHIBITION EXCITANTS

作　　者：朱显峰[1] 史轶蘩[1] 高素敏[1] 张殿喜[1] 邓洁英[1] 张晋熙 戴晴[1] 

机构地区：[1]北京协和医院内分泌科

出　　处：《中华内科杂志》1994年第2期87-91,共5页Chinese Journal of Internal Medicine

摘　　要：为了探索克服长效生长抑素激动剂ＳＭＳ２０１－９９５治疗肢端肥大症（肢大）引起胆囊结石的方法，我们前瞻性地观察了１４例经ＳＭＳ治疗的肢大患者于停用ＳＭＳ后生长激素分泌轴系变化及胆囊病变的恢复情况。结果：停用ＳＭＳ后第１周，周围血中生长激素基础值及５小时生长激素谱中生长激素平均水平均显著低于用药前水平，分别为用药前生长激素水平的３６％和２４％。在停药后２周未，则生长激素基础值和５小时生长激素谱平均水平分别为用药前的６０％和５６％。在６例没有形成胆囊结石的肢大患者中，胆囊相对收缩率在停药后１周内恢复正常，在８例已形成胆囊结石的肢大患者中，３例在停药后２周内胆囊收缩功能恢复正常，４例在停药后１月内排尽胆囊结石。我们的结果显示，采取ＳＭＳ间歇给药的方法对预防ＳＭＳ治疗诱发胆囊结石形成可能有益。e sought to examine the feasibility of intermittent dosing of cotreotide in acromegalics to avoidthe well-documented side effect of cholelithiasis.In fourteen acromegalic patients,we measured serumGH, five hour GH profile(mean GH,measured hourly 8:00 am to 12:00pm) prior to thediscontinuation of octreotide and weekly thereafter.In addition,gallbladder contractility was quantitat-ed using the percent of relative gallbladder contractility(PRGC) obtained by ultrasound during a fatmeal test.One week after withdrawal of octreotide、basal GH and five our GH profile(14.6 ± 3.3μg/L。1 3.4±3.2μg/L,respectively)were significantly less than(P<0.01,P<0.05),and represented 36% and24% of their respective pretreatment values.At the end of two weeks,these parameters were 60% and56% of their pretreatment levels.We also measured serum octreotide levels following withdrawal;thedrug is completely eliminated from the serum within 3 day In all of 6 patients who did not developstones, PRGC normalized within one week. In 8 patients who developed stones,3 of them had restora. tion of normal contractility in 2 weeks.Our results show that upon withdrawal of octreotide,gall blad-der contractility normalizes while GH suppression persists for a longer period of time.Therefore,inter-mittent therapy may allow clearance of stagnated bile and hence decrease the incidence of cholelithiasisin acromegalic patients receiving long term octreotide therapy.

关 键 词：肢端肥大症 生长激素 生长抑素 

分 类 号：R584.110.5[医药卫生—内分泌]