Sicolo N, Martini C, Ferla S, Roggenkamp J, Vettor R, De Palo C, Federspil G
Università di Padova, Ospedale Civile di Padova.
Minerva Endocrinol. 1990 Jan-Mar;15(1):37-42.
Somatostatin analogue (Sandostatin; SMS 201-995) is utilized as a therapy in acromegaly because of its efficiency in inhibiting GH secretion; it induces some clinical improvements, such as headache remission in acromegalic patient, which seem to be unrelated to Gh normalization. We have examined 8 acromegalic patients, suffering from headache, after injection of saline solution and subsequently of SMS 201-995 (100 y), in order to study the mechanism of analgesic effect induced by Sandostatin administration. Headache, by autovaluation test, heart rate frequency, PAO, sistolic and diastolic blood velocity in medial cerebral artery, by utilizing Transcranial Doppler Sonography (SDSV), have been measured before and after saline and after SMS 201-995. GH and beta-endorphin have been also assayed in plasma samples. All patients have shown a rapid and complete improvement in headache after Sandostatin administration. At the same time we have observed an increase in SDSV and a parallel slight increase in PAO values, more evident in the diastolic phase. Plasma beta-endorphin assay has shown rather conflicting results after SMS 201-995 administration. Our results confirm an important and rapid analgesis effect of Sandostatin on acromegaly headache unrelated to GH normalization. The cerebral emodinamic changes suggest their involvement in Sandostatin induced analgesia.
生长抑素类似物（善得定；SMS 201-995）因其抑制生长激素（GH）分泌的功效而被用于治疗肢端肥大症；它能带来一些临床改善，比如肢端肥大症患者头痛缓解，而这似乎与GH恢复正常无关。我们对8名患有头痛的肢端肥大症患者进行了研究，先给他们注射生理盐水，随后注射SMS 201-995（100微克），以研究善得定给药诱导镇痛作用的机制。通过自我评估测试、心率频率、利用经颅多普勒超声（TCD）测量大脑中动脉的平均动脉压（MAP）、收缩期和舒张期血流速度，在注射生理盐水后以及注射SMS 201-995后进行测量。还对血浆样本中的GH和β-内啡肽进行了检测。所有患者在注射善得定后头痛均迅速且完全缓解。与此同时，我们观察到血流速度增加，MAP值同时略有升高，在舒张期更明显。注射SMS 201-995后，血浆β-内啡肽检测结果相当矛盾。我们的结果证实了善得定对肢端肥大症头痛具有重要且快速的镇痛作用，这与GH恢复正常无关。脑部血液动力学变化表明它们参与了善得定诱导的镇痛过程。
