Gullo L, Priori P, Scarpignato C, Baldoni F, Mattioli G, Barbara L
Institute of Medicine and Gastroenterology, University of Bologna, St. Orsola Hospital, Italy.
Dig Dis Sci. 1987 Oct;32(10):1065-70. doi: 10.1007/BF01300189.
While it is well known that large doses of somatostatin inhibit human pancreatic enzyme secretion, it is still unknown whether low doses are also effective and whether the peptide is able to inhibit bicarbonate production. Eight subjects with external transduodenal drainage of the main pancreatic duct performed after biliary tract surgery were studied. Somatostatin was infused at progressively increasing rates of 0.05, 0.15, 0.45, and 1.35 micrograms/kg/hr, for 30 min/dose, during pancreatic stimulation with secretin, 25 ng/kg/hr, and cerulein, 10 ng/kg/hr. Somatostatin, at the dose of 0.05 microgram/kg/hr (shown to produce blood levels similar to those measured after a meal) did not affect pancreatic secretion in any of the subjects. The successive three higher doses caused a significant and dose-dependent inhibition of protein concentration and output and of bicarbonate output. Bicarbonate concentration was slightly but significantly reduced only by the two highest doses of somatostatin. At each dose level, the inhibition of protein output was much more marked than the inhibition of bicarbonate output. The maximal inhibition of protein output (at 1.35 micrograms/kg/hr somatostatin) was 73.9 +/- 5.4%, and that of bicarbonate output was 55.9 +/- 6.4%. The results demonstrate that: (1) the administration of somatostatin at a low dose level does not affect human exocrine pancreatic secretion, at least under the experimental conditions of this study; and (2) the administration of larger doses of somatostatin inhibits pancreatic secretion of both protein and bicarbonate dose-dependently. The inhibitory effect on protein output is significantly greater than that on water and bicarbonate production.
虽然众所周知大剂量生长抑素可抑制人胰酶分泌,但小剂量是否也有效以及该肽是否能够抑制碳酸氢盐生成仍不清楚。对8例在胆道手术后进行主胰管十二指肠外引流的受试者进行了研究。在用25 ng/kg/hr促胰液素和10 ng/kg/hr蛙皮素刺激胰腺期间,以0.05、0.15、0.45和1.35微克/千克/小时逐渐增加的速率输注生长抑素,每剂量输注30分钟。0.05微克/千克/小时剂量的生长抑素(其产生的血药浓度与餐后测得的相似)对任何受试者的胰腺分泌均无影响。随后的三个更高剂量导致蛋白质浓度、输出量以及碳酸氢盐输出量出现显著的剂量依赖性抑制。仅两种最高剂量的生长抑素使碳酸氢盐浓度略有但显著降低。在每个剂量水平,蛋白质输出量的抑制均比碳酸氢盐输出量的抑制更为明显。蛋白质输出量的最大抑制(在1.35微克/千克/小时生长抑素时)为73.9±5.4%,碳酸氢盐输出量的最大抑制为55.9±6.4%。结果表明:(1)至少在本研究的实验条件下,低剂量水平给予生长抑素不影响人胰腺外分泌;(2)给予较大剂量的生长抑素可剂量依赖性地抑制胰腺蛋白质和碳酸氢盐的分泌。对蛋白质输出量的抑制作用明显大于对水和碳酸氢盐生成的抑制作用。