减少 ADPKD 患者的多囊肝体积：生长抑素类似物奥曲肽的作用。
Reducing polycystic liver volume in ADPKD: effects of somatostatin analogue octreotide.
机构信息
Biomedical Engineering, Mario Negri Institute for Pharmacological Research, Via Gavazzeni, 11, 24125 Bergamo, Italy.
出版信息
Clin J Am Soc Nephrol. 2010 May;5(5):783-9. doi: 10.2215/CJN.05380709. Epub 2010 Feb 25.
BACKGROUND AND OBJECTIVES
No medical treatment is available for polycystic liver disease, a frequent manifestation of autosomal-dominant polycystic kidney disease (ADPKD). In a prospective, randomized, double-blind, crossover study, 6 months of octreotide (40 mg every 28 days) therapy limited kidney volume growth more effectively than placebo in 12 patients with ADPKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this secondary, post hoc analysis of the above study, octreotide-induced changes in liver volumes compared with placebo and the relationship between concomitant changes in liver and kidney volumes were evaluated. Those analyzing liver and kidney volumes were blinded to treatment.
RESULTS
Liver volumes significantly decreased from 1595 +/- 478 ml to 1524 +/- 453 ml with octreotide whereas they did not appreciably change with placebo. Changes in liver volumes were significantly different between the two treatment periods (-71 +/- 57 ml versus +14 +/- 85 ml). Octreotide-induced liver volume reduction was fully explained by a reduction in parenchyma volume from 1506 +/- 431 ml to 1432 +/- 403 ml. Changes in liver volumes were significantly correlated with concomitant changes in kidney volumes (r = 0.67) during octreotide but not during placebo treatment. Liver and kidney volume changes significantly differed with both treatments (octreotide: -71 +/- 57 ml versus +71 +/- 107; placebo: +14 +/- 85 ml versus +162 +/- 114), but net reductions in liver (-85 +/- 103 ml) and kidney (-91 +/- 125 ml) volume growth on octreotide versus placebo were similar.
CONCLUSIONS
Octreotide therapy reduces liver volumes in patients with ADPKD and is safe.
背景与目的
多囊肝是常染色体显性多囊肾病（ADPKD）的一种表现，目前尚无有效的治疗方法。在一项前瞻性、随机、双盲、交叉研究中，12 例 ADPKD 患者接受奥曲肽（40mg/28d）治疗 6 个月，与安慰剂相比，更有效地限制了肾脏体积的增长。
设计、地点、参与者和测量方法：在上述研究的二次、事后分析中，评估了奥曲肽引起的肝体积变化与安慰剂的比较，以及肝和肾体积同时变化之间的关系。分析肝和肾体积的人员对治疗情况不知情。
结果
与安慰剂相比，奥曲肽可使肝体积从 1595±478ml 显著下降至 1524±453ml，而安慰剂组肝体积无明显变化。两个治疗期之间肝体积的变化差异具有统计学意义（-71±57ml 与 +14±85ml）。奥曲肽诱导的肝体积减少完全由实质体积从 1506±431ml 减少至 1432±403ml 解释。奥曲肽治疗期间，肝体积的变化与同期肾体积的变化显著相关（r=0.67），但安慰剂治疗期间无相关性。两种治疗方法均使肝和肾体积发生显著变化（奥曲肽：-71±57ml 与 +71±107ml；安慰剂：+14±85ml 与 +162±114ml），但奥曲肽与安慰剂相比，肝（-85±103ml）和肾（-91±125ml）体积生长的净减少量相似。
结论
奥曲肽治疗可减少 ADPKD 患者的肝体积，且安全。
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