Magnusson I
Dept. of Surgery, Södersjukhuset, Stockholm, Sweden.
Scand J Gastroenterol Suppl. 1987;137:56-60. doi: 10.3109/00365528709089763.
Secretin inhibits gastric secretion of acid and gastrin in dog and a physiological role of secretin as an enterogastrone has been suggested in this species. In man there are diverging results concerning the effect of secretin on gastric secretion. Secretin has been used in patients with upper gastrointestinal bleeding and positive results have been reported, but the patients included in these studies cannot be considered as massive bleeders. Until now no double-blind study comparing secretin with placebo has been reported. Somatostatin decreases splanchnic blood flow and gastric secretion in man. Somatostatin seems to be effective in achieving initial haemostasis in patients with bleeding oesophageal varices. The peptide has also been shown to stop severe and persistent peptic ulcer haemorrhage and to stop bleeding in patients treated with steroidal and non-steroidal anti-inflammatory drugs. In one double-blind trial in patients with upper gastrointestinal bleeding, somatostatin had no effect on either the number of emergency operations or the number of rebleedings. In another double blind study, when somatostatin was compared with placebo in patients with massive upper gastrointestinal bleeding, the peptide reduced the number of emergency operations. In conclusion, most studies show positive effects of somatostatin on variceal and peptic ulcer haemorrhage.
促胰液素可抑制犬胃酸和胃泌素的分泌，提示其在该物种中作为肠抑胃素发挥生理作用。关于促胰液素对人类胃酸分泌的影响，结果存在分歧。促胰液素已用于上消化道出血患者，并报告了阳性结果，但这些研究中的患者不能视为大量出血者。迄今为止，尚未有比较促胰液素与安慰剂的双盲研究报告。生长抑素可减少人类内脏血流量和胃酸分泌。生长抑素似乎对食管静脉曲张出血患者实现初始止血有效。该肽还被证明可停止严重且持续的消化性溃疡出血，并使接受甾体和非甾体抗炎药治疗的患者止血。在一项针对上消化道出血患者的双盲试验中，生长抑素对急诊手术数量或再出血数量均无影响。在另一项双盲研究中，当将生长抑素与安慰剂在大量上消化道出血患者中进行比较时，该肽减少了急诊手术数量。总之，大多数研究表明生长抑素对静脉曲张和消化性溃疡出血有积极作用。
