Gragnoli G, Signorini A M, Tanganelli I
Acta Endocrinol (Copenh). 1985 May;109(1):104-7. doi: 10.1530/acta.0.1090104.
Pharmacological studies have shown that the addition of somatostatin to insulin promotes a more rapid recovery from diabetic ketoacidosis. However, contradictory results have been reported concerning the action of somatostatin on platelet function, frequently deranged in diabetes. Therefore the plasma levels of thromboxane B2, a stable metabolite of proaggregatory thromboxane A2 and of beta-thromboglobulin, a marker of platelet activation, were studied in 9 control subjects and in 13 insulin-dependent diabetic patients before and during somatostatin injection, administered as an initial 250 micrograms iv bolus followed by infusion of 300 micrograms over 3 h. In both groups, after somatostatin infusion thromboxane B2 and beta-thromboglobulin levels showed, respectively, a progressive fall and an increase up to the second hour. Over the next hour thromboxane B2 increased and beta-thromboglobulin decreased but their levels did not return to basal values. During this experiment beta-thromboglobulin plasma values in diabetic patients did not differ from those of control subjects. In contrast, thromboxane B2, decreased in relation to pharmacological treatment, maintained elevated levels. Our data, however, demonstrate that the dose of somatostatin used, produced in the diabetic patients a normal fall of thromboxane B2 in terms of percentage of base-line values, but increases of beta-thromboglobulin lower than in control subjects. It is suggested that platelet function should be evaluated when somatostatin is used in the treatment of poorly controlled type I diabetes.
药理学研究表明,在胰岛素中加入生长抑素可促进糖尿病酮症酸中毒更快恢复。然而,关于生长抑素对血小板功能的作用,已有相互矛盾的报道,而血小板功能在糖尿病中常常紊乱。因此,我们对9名对照受试者和13名胰岛素依赖型糖尿病患者在注射生长抑素之前及期间的血浆血栓素B2(促聚集性血栓素A2的稳定代谢产物)水平以及β-血小板球蛋白(血小板活化标志物)水平进行了研究。生长抑素的给药方式为:先静脉推注250微克,随后在3小时内输注300微克。在两组中,生长抑素输注后,血栓素B2水平逐渐下降,β-血小板球蛋白水平在第二个小时前升高。在接下来的一小时内,血栓素B2升高,β-血小板球蛋白下降,但它们的水平未恢复到基础值。在该实验中,糖尿病患者的β-血小板球蛋白血浆值与对照受试者无差异。相比之下,血栓素B2虽因药物治疗而降低,但仍维持在较高水平。然而,我们的数据表明,所用生长抑素剂量使糖尿病患者的血栓素B2相对于基线值的百分比出现正常下降,但β-血小板球蛋白的升高低于对照受试者。建议在使用生长抑素治疗控制不佳的I型糖尿病时,应评估血小板功能。