Moschetta A, Stolk M F, Rehfeld J F, Portincasa P, Slee P H, Koppeschaar H P, Van Erpecum K J, Vanberge-Henegouwen G P
Department of Gastroenterology, University Medical Center Utrecht, the Netherlands.
Aliment Pharmacol Ther. 2001 Feb;15(2):181-5. doi: 10.1046/j.1365-2036.2001.00924.x.
Acromegalic patients treated three times daily with subcutaneous injections of the somatostatin analogue octreotide frequently develop gallstones, due to suppressed cholecystokinin release and impaired gall-bladder emptying.
To elucidate the effects of a new long-acting octreotide formulation (Sandostatin LAR) on gall-bladder emptying, cholecystokinin release and gallstone formation.
Postprandial gall-bladder and gastric emptying were determined by ultrasonography and cholecystokinin release was measured in seven patients on days 0, 14, 28, and 75 (Sandostatin LAR, 20 mg intramuscularly on days 1, 30, and 60).
During treatment, fasting gall-bladder volumes increased from 26.5 +/- 3.2 mL to 61.4 +/- 7.5 mL, but postprandial cholecystokinin release and gall-bladder emptying (from 63.9 +/- 3.8% to 12.3 +/- 3.5%) were severely suppressed. Gallstones formed in six out of seven patients within 8 months of treatment. Gastric emptying did not change during the therapy.
The risk of gallstone formation is greatly increased during Sandostatin LAR. This is probably related to profound suppression of cholecystokinin release and gall-bladder emptying.
因生长抑素释放受抑制和胆囊排空受损，每天接受三次皮下注射生长抑素类似物奥曲肽治疗的肢端肥大症患者经常会形成胆结石。
阐明新型长效奥曲肽制剂（善龙）对胆囊排空、胆囊收缩素释放和胆结石形成的影响。
通过超声检查测定7例患者在第0、14、28和75天的餐后胆囊和胃排空情况，并测量胆囊收缩素释放情况（善龙，在第1、30和60天肌肉注射20mg）。
治疗期间，空腹胆囊容积从26.5±3.2ml增加到61.4±7.5ml，但餐后胆囊收缩素释放和胆囊排空（从63.9±3.8%降至12.3±3.5%）受到严重抑制。7例患者中有6例在治疗8个月内形成胆结石。治疗期间胃排空未发生变化。
使用善龙期间胆结石形成风险大幅增加。这可能与胆囊收缩素释放和胆囊排空受到深度抑制有关。
