【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。更多还原

【Abstract】 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.更多还原