Hopman W P, Wolberink R G, Lamers C B, Van Tongeren J H
Department of Gastroenterology and Hepatology, University Hospital Nijmegen, The Netherlands.
Ann Surg. 1988 Feb;207(2):155-9. doi: 10.1097/00000658-198802000-00007.
In six patients suffering from severe early dumping and six patients with late dumping after peptic ulcer surgery, the effect of the somatostatin analogue SMS 201-995 was compared with placebo. In early dumpers subcutaneous administration of 50 micrograms SMS 201-995 prior to meal ingestion induced a strong improvement of dumping symptoms as reflected by a decrease of the Sigstad dumping score from 12 +/- 2 during placebo to 5 +/- 2 (p less than 0.05). Furthermore, the postprandial increase of pulse rate was abolished; maximum pulse rate decreased from 85 +/- 7 beats/min to 67 +/- 7 beats/min (p less than 0.05). SMS 201-995 did not significantly affect postprandial changes in packed cell volume. In late dumpers 50 micrograms SMS 201-995 reduced peak plasma insulin after oral glucose from 173 +/- 16 mU/L during placebo to 35 +/- 9 mU/L during SMS 201-995 (p less than 0.05) and increased individual plasma glucose nadirs from 1.9 +/- 0.3 mmol/L to 7.5 +/- 3.3 mmol/L (p less than 0.01). Both in early and late dumpers SMS 201-995 improved postprandial expiratory breath hydrogen excretion indicating slowing of gastrointestinal hurry. SMS 201-995 is a powerful therapeutic agent for the management of patients suffering from the dumping syndrome after gastric surgery.
在6例患有严重早期倾倒综合征和6例患有消化性溃疡手术后晚期倾倒综合征的患者中，比较了生长抑素类似物SMS 201-995与安慰剂的效果。在早期倾倒综合征患者中，餐前皮下注射50微克SMS 201-995可使倾倒症状明显改善，这表现为Sigstad倾倒评分从安慰剂期间的12±2降至5±2（p<0.05）。此外，餐后脉搏率的增加被消除；最大脉搏率从85±7次/分钟降至67±7次/分钟（p<0.05）。SMS 201-995对餐后红细胞压积的变化没有显著影响。在晚期倾倒综合征患者中，50微克SMS 201-995可使口服葡萄糖后的血浆胰岛素峰值从安慰剂期间的173±16 mU/L降至SMS 201-995期间的35±9 mU/L（p<0.05），并使个体血浆葡萄糖最低点从1.9±0.3 mmol/L升至7.5±3.3 mmol/L（p<0.01）。在早期和晚期倾倒综合征患者中，SMS 201-995均改善了餐后呼气氢排泄，表明胃肠道蠕动减慢。SMS 201-995是治疗胃手术后倾倒综合征患者的一种有效治疗药物。
