Faglia G, Arosio M
Istituto di Scienze endocrine, Università, Milano.
Recenti Prog Med. 1992 Nov;83(11):626-33.
The recent availability of the long-acting somatostatin analogue, octreotide, has allowed its therapeutical use in a wide variety of human diseases, including some digestive, neoplastic and autoimmune disorders. This review focuses on the treatment of some endocrine disorders with octreotide. Evidence is accumulating that octreotide treatment is effective in improving the cure rate of pituitary surgery in acromegaly by shrinking the tumour size, and in lowering GH and IGF-I levels in the vaste majority of patients. Octreotide is also effective in ameliorating TSH-induced hyperthyroidism in patients with TSH-secreting adenomas. Moreover, octreotide has proved useful in the management of endocrine tumours of the gastroenteropancreatic tract (vipomas, glucagonomas, gastrinomas, insulinomas, and carcinoids) by reducing hormone levels and in some instances the size of the primary and/or metastatic lesions. Besides the above well-established indications there are some other potential indications (non-secreting pituitary tumours, medullary thyroid carcinoma, ectopic Cushing's syndrome, diabete mellitus, Graves' ophthalmopathy, tall children and polycystic ovary syndrome) that still await further investigation. Side-effects of octreotide, particularly the formation of gallstones, should be carefully monitored.
长效生长抑素类似物奥曲肽的问世,使其得以用于多种人类疾病的治疗,包括一些消化系统、肿瘤及自身免疫性疾病。本综述聚焦于奥曲肽对某些内分泌疾病的治疗。越来越多的证据表明,奥曲肽治疗可通过缩小肿瘤体积提高肢端肥大症垂体手术的治愈率,并使绝大多数患者的生长激素(GH)和胰岛素样生长因子-I(IGF-I)水平降低。奥曲肽对改善促甲状腺激素分泌腺瘤患者由促甲状腺激素(TSH)引起的甲状腺功能亢进也有效。此外,奥曲肽已被证明对胃肠胰内分泌肿瘤(血管活性肠肽瘤、胰高血糖素瘤、胃泌素瘤、胰岛素瘤及类癌)的治疗有用,可降低激素水平,在某些情况下还可缩小原发和/或转移病灶的大小。除上述已确立的适应证外,还有一些其他潜在适应证(无分泌功能的垂体肿瘤、甲状腺髓样癌、异位库欣综合征、糖尿病、格雷夫斯眼病、身材高大儿童及多囊卵巢综合征)仍有待进一步研究。奥曲肽的副作用,尤其是胆结石的形成,应予以密切监测。