Kafali M Ertugrul, Gul Mehmet, Alptekin Husnu, Sahin Mustafa, Toy Hatice, Akoz Mehmet
Department of Surgery, Selcuklu Medical Faculty, Selcuk University, Konya, Turkey.
J Korean Surg Soc. 2012 May;82(5):296-301. doi: 10.4174/jkss.2012.82.5.296. Epub 2012 Apr 26.
The efficacy of octreotide in the treatment of acute pancreatitis is controversial. Octreotide treatment for acute pancreatitis often shows poor correlation between results obtained in experimental studies and results of clinical trials. In a clinical setting, there is always a delay between the onset of the disease and initiation of the octreotide treatment. The aim of this study is to investigate the relationship between the beginning of treatment and alteration in effectiveness of octreotide.
Acute pancreatitis was induced by pancreatic duct ligation in 50 rats. The rats were randomly divided into five groups. Octreotide was not used in group 1 (control group). Only single dose (4 µg/kg) octreotide was administered subcutaneously to rats in group 2, having induced pancreatitis. Octreotide treatment was begun at different times (8th, 24th, 48th hour) in three other groups and continued treatment at a dosage of 4 µg/kg t.i.d. The animals were sacrificed at the end of the 72nd hour and blood and tissue samples were collected.
Leukocyte count and plasma amylase values were less in groups 2 and 3. Hemorrhagic focuses were encountered less at pancreas tissues in group 3. Pancreatic necrosis and alveolar capillary basal membrane damage were lower in groups 3 and 4. No difference was found in fasting blood glucose, calcium and hematocrit.
Octreotide had benefical effects in acute pancreatitis when octreotide treatment was begun in the first 24 hours.
奥曲肽治疗急性胰腺炎的疗效存在争议。奥曲肽治疗急性胰腺炎时,实验研究结果与临床试验结果之间往往相关性较差。在临床环境中,疾病发作与奥曲肽治疗开始之间总是存在延迟。本研究的目的是探讨治疗开始时间与奥曲肽疗效改变之间的关系。
通过结扎胰管诱导50只大鼠发生急性胰腺炎。将大鼠随机分为五组。第1组(对照组)不使用奥曲肽。第2组诱导胰腺炎的大鼠仅皮下注射单剂量(4μg/kg)奥曲肽。其他三组在不同时间(第8、24、48小时)开始奥曲肽治疗,并以4μg/kg每日三次的剂量持续治疗。在第72小时结束时处死动物,收集血液和组织样本。
第2组和第3组的白细胞计数和血浆淀粉酶值较低。第3组胰腺组织中出现的出血灶较少。第3组和第4组的胰腺坏死和肺泡毛细血管基底膜损伤较轻。空腹血糖、钙和血细胞比容无差异。
在急性胰腺炎发病后的前24小时内开始使用奥曲肽治疗,奥曲肽具有有益作用。