Atkinson A B, McKnight J A, McCance D R, Bell P M
Sir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, UK.
Horm Res. 1990;33 Suppl 1:7-11; discussion 11-2. doi: 10.1159/000181548.
The results of treating 10 acromegalic patients with octreotide are compared with those of bromocriptine. Bromocriptine (5 mg 4 times daily for 5 weeks) reduced mean growth hormone (GH) concentrations from 60 to 35 mU/l in 8 patients; a further 2 patients were unable to tolerate this dose. Ten patients (8 unresponsive to bromocriptine) received octreotide 100 micrograms 3 times daily, rising to 500 micrograms 3 times daily according to monthly 24-hour GH profiles. Two patients were withdrawn from octreotide therapy; in the remaining 8, mean GH fell from 36 to 11 mU/l after 6 months' therapy (a reduction to 22% of basal concentrations, compared to a reduction to 58% on bromocriptine). Asymptomatic changes of glucose tolerance and the development of gallstones were noted; further information on the latter is urgently required. In summary, the smallest effective dose of octreotide should be used and each patient should be monitored biochemically.
将10例肢端肥大症患者使用奥曲肽的治疗结果与使用溴隐亭的结果进行了比较。溴隐亭（每日4次，每次5mg，共5周）使8例患者的平均生长激素（GH）浓度从60mU/L降至35mU/L；另有2例患者无法耐受该剂量。10例患者（8例对溴隐亭无反应）接受奥曲肽治疗，初始剂量为每日3次，每次100μg，根据每月24小时GH水平，剂量逐渐增加至每日3次，每次500μg。2例患者退出奥曲肽治疗；其余8例患者在治疗6个月后，平均GH从36mU/L降至11mU/L（降至基础浓度的22%，而溴隐亭治疗时降至58%）。观察到葡萄糖耐量出现无症状变化以及胆结石形成；迫切需要关于后者的更多信息。总之，应使用最小有效剂量的奥曲肽，并对每位患者进行生化监测。
