Lamberts S W, del Pozo E
Department of Medicine, Erasmus University, Rotterdam, The Netherlands.
Horm Res. 1988;29(2-3):115-7. doi: 10.1159/000180984.
Ten acromegalics received daily doses of 200-300 micrograms of a long-acting somatostatin analog, SMS 201-995 (Sandostatin, SMS), for an average of 64 weeks. Basal mean GH values of 44 +/- (SE) 7.8 ng/ml had fallen into the normal range at the end of the observation period (mean 64 weeks). This effect was accompanied by a substantial drop in somatomedin-C values. Reduction of pituitary tumor size could be documented in 3 of 6 patients. Whereas SMS did not affect high plasma PRL in 4 microprolactinoma patients, lactotrophs turned sensitive to this agent in mixed GH/PRL tumors. In a comparative study between SMS and bromocriptine, the former normalized circulating GH in 10 of 17 acromegalics in an acute trial, whereas bromocriptine was effective in only 5. A combination of both substances was effective in 2 of 3 patients who were insensitive to single drug administration. Cultures of GH-secreting tumor cells showed a statistically significant hormone decrease in the medium when exposed to SMS. However, in some instances, a diminution of the GH contents of the tumor cells was also observed, presumably as the basis for intracellular breakdown and clinical tumor shrinkage.
10例肢端肥大症患者每日接受200 - 300微克长效生长抑素类似物SMS 201 - 995（善得定，SMS）治疗，平均治疗64周。观察期末（平均64周），基础平均生长激素（GH）值从44±（标准误）7.8纳克/毫升降至正常范围。此效应伴随着胰岛素样生长因子-C值的大幅下降。6例患者中有3例垂体肿瘤大小有所缩小。4例微泌乳素瘤患者中，SMS对高血浆泌乳素（PRL）水平无影响，而在生长激素/泌乳素混合瘤中，泌乳细胞对此药物变得敏感。在SMS与溴隐亭的一项对比研究中，在急性试验中，前者使17例肢端肥大症患者中的10例循环GH恢复正常，而溴隐亭仅使5例有效。两种药物联合使用对3例对单一药物治疗不敏感的患者中的2例有效。分泌生长激素的肿瘤细胞培养显示，当暴露于SMS时，培养基中的激素有统计学意义的减少。然而，在某些情况下，也观察到肿瘤细胞内生长激素含量减少，这可能是细胞内分解和临床肿瘤缩小的基础。
