Timsit J, Chanson P, Larger E, Duet M, Mosse A, Guillausseau P J, Harris A G, Moulonguet M, Warnet A, Lubetzki J
Department of Endocrinology, Hôpital Lariboisiere, Paris, France.
Acta Endocrinol (Copenh). 1987 Sep;116(1):108-12. doi: 10.1530/acta.0.1160108.
Multiple sc injections of a long-acting somatostatin analogue (SMS 201-995) are currently used in the treatment of acromegaly. However, plasma GH concentration often reaches a pathological level (less than 5 micrograms/l) between two injections. In seven patients with active acromegaly we compared, in a short-term trial, the effect of SMS 201-995 administered by continuous sc infusion (50 micrograms and 100 micrograms a day) and by three sc injections (100 micrograms each). In six patients, plasma GH levels were significantly reduced regardless of the mode and dose of treatment (P less than 0.05). However, comparing diurnal profiles, 100 micrograms continuous sc infusion was more effective than discontinuous administration in reducing the number of GH levels above 5 micrograms/l (P less than 0.01). In two patients, continuous infusion was the only way to decrease all plasma GH values below 5 micrograms/l during the diurnal profile determination. Moreover, even when, in a long-term study, the dose of multiple injections was progressively increased to 500 micrograms three times a day, GH levels remained consistently elevated in one of these patients. Thus, in some acromegalic patients continuous sc injection seems currently the most efficient way of treatment with SMS 201-995.
长效生长抑素类似物（SMS 201-995）的多次皮下注射目前用于治疗肢端肥大症。然而，两次注射之间血浆生长激素（GH）浓度常常会达到病理水平（低于5微克/升）。在一项短期试验中，我们比较了7例活动期肢端肥大症患者连续皮下输注（每天50微克和100微克）和三次皮下注射（每次100微克）SMS 201-995的效果。在6例患者中，无论治疗方式和剂量如何，血浆GH水平均显著降低（P<0.05）。然而，比较昼夜变化曲线，100微克连续皮下输注在降低GH水平高于5微克/升的次数方面比间断给药更有效（P<0.01）。在2例患者中，连续输注是在昼夜变化曲线测定期间将所有血浆GH值降至5微克/升以下的唯一方法。此外，即使在一项长期研究中，多次注射的剂量逐渐增加至每天三次500微克，其中1例患者的GH水平仍持续升高。因此，对于一些肢端肥大症患者，目前连续皮下注射似乎是使用SMS 201-995最有效的治疗方法。
