Plöckinger U, Dienemann D, Quabbe H J
Department of Internal Medicine, Freie Universität, Berlin, Germany.
J Clin Endocrinol Metab. 1990 Dec;71(6):1658-62. doi: 10.1210/jcem-71-6-1658.
Gastrointestinal side-effects of prolonged therapy (greater than 2 yr) with the long-acting somatostatin analog octreotide were studied in 10 acromegalic patients. After 2 yr of therapy, 6 of 10 patients had newly developed gallstones, complicated by cholangitis and jaundice in 1. Serum vitamin B-12 concentrations declined in all 10 patients [from 380 +/- 32 to 172 +/- 21 pmol/L (mean +/- SE); P = 0.023] and became abnormally low in 4. Gastric biopsy specimens, obtained during gastroscopy (9 patients), showed moderate to severe active gastritis, with damage to the superficial and deeper layers of the mucosa in 9 of 9 and focal atrophy in 7 of 9 patients. Campylobacter pylori was found in the antral mucosa in 8 of 9 patients. Although information is lacking on similar studies in untreated acromegalic patients, we suggest that patients receiving chronic octreotide therapy be closely monitored for these and possible other side-effects related to gastrointestinal actions of octreotide.
对10例肢端肥大症患者进行了研究，观察长效生长抑素类似物奥曲肽长期治疗（超过2年）的胃肠道副作用。治疗2年后，10例患者中有6例新出现胆结石，其中1例并发胆管炎和黄疸。所有10例患者的血清维生素B12浓度均下降[从380±32降至172±21 pmol/L（均值±标准误）；P = 0.023]，4例患者降至异常低水平。在胃镜检查时获取的胃活检标本（9例患者）显示，9例患者中有9例存在中度至重度活动性胃炎，黏膜表层和深层均有损伤，9例患者中有7例存在局灶性萎缩。9例患者中有8例在胃窦黏膜中发现幽门螺杆菌。尽管缺乏未接受治疗的肢端肥大症患者的类似研究信息，但我们建议对接受奥曲肽长期治疗患者密切监测这些以及可能出现的与奥曲肽胃肠道作用相关的其他副作用。
