Penning C, Vecht J, Masclee A A M
Department of Gastroenterology-Hepatology, Leiden University Medical Center, The Netherlands.
Aliment Pharmacol Ther. 2005 Nov 15;22(10):963-9. doi: 10.1111/j.1365-2036.2005.02681.x.
Dumping syndrome is a serious complication occurring in 10% of patients after gastric surgery. Dumping symptoms are effectively reduced by subcutaneous application of the somatostatin analogue octreotide, but side-effects limit its use.
To evaluate the efficacy of depot long-acting release octreotide (Sandostatin-LAR) vs. octreotide subcutaneous on dumping symptoms, quality of life and side-effects.
Twelve patients (five females, age 58 +/- 3 years) with severe dumping symptoms, requiring daily use of octreotide subcutaneous, were included in an open study and changed from octreotide subcutaneous after a 2 weeks washout to Sandostatin-LAR 10 mg i.m., every 4 weeks for 6 months. Symptoms (diary), body weight, fat excretion, food intake and Gastrointestinal Specific Quality of Life Index were evaluated.
Gastrointestinal Specific Quality of Life Index increased significantly (P < 0.05) during Sandostatin-LAR treatment (88 +/- 4) compared with octreotide (74 +/- 4) and washout (75 +/- 6). During Sandostatin-LAR treatment, abdominal symptom score was lower compared with octreotide and washout, but not significantly. During Sandostatin-LAR treatment, body weight increased (66 +/- 4 to 70 +/- 3 kg; P = 0.19).
Sandostatin-LAR is at least as effective as octreotide subcutaneous in suppressing symptoms in patients with severe dumping syndrome and is more effective than octreotide subcutaneous in increasing body weight and quality of life.
倾倒综合征是胃手术后10%的患者会出现的一种严重并发症。皮下注射生长抑素类似物奥曲肽可有效减轻倾倒症状,但副作用限制了其使用。
评估长效奥曲肽(善龙)与皮下注射奥曲肽在减轻倾倒症状、改善生活质量及副作用方面的疗效。
12例(5例女性,年龄58±3岁)有严重倾倒症状、每日需皮下注射奥曲肽的患者纳入一项开放性研究,在经过2周的洗脱期后,由皮下注射奥曲肽改为每4周肌肉注射10mg善龙,共6个月。评估症状(日记记录)、体重、脂肪排泄、食物摄入量及胃肠道特异性生活质量指数。
与奥曲肽治疗期(74±4)及洗脱期(75±6)相比,善龙治疗期胃肠道特异性生活质量指数显著升高(P<0.05)(88±4)。在善龙治疗期,腹部症状评分低于奥曲肽治疗期及洗脱期,但差异无统计学意义。在善龙治疗期,体重增加(从66±4kg增至70±3kg;P=0.19)。
在抑制严重倾倒综合征患者症状方面,善龙至少与皮下注射奥曲肽同样有效,且在增加体重及改善生活质量方面比皮下注射奥曲肽更有效。