Venier A, De Simone C, Forni L, Ghirlanda G, Uccioli L, Serri F, Frati L
Department of Dermatology, Catholic University, Rome, Italy.
Arch Dermatol Res. 1988;280 Suppl:S51-4.
Over a period of 4 years, 20 patients suffering from severe forms of psoriasis (erythrodermic, sub-erythrodermic, resistant generalized forms and/or forms associated with acute arthropathy) were treated with 96 h of continuous i.v. infusion of somatostatin (Stilamin, Serono) diluted in D5W at 250 micrograms/h. In addition to the usual blood chemistry parameters, circadian levels of growth hormone (GH) and epidermal growth factor (EGF) were measured before, during, and after therapy. Approximately 2-3 weeks after termination of therapy, erythrodermic and suberythrodermic symptoms had disappeared. In some patients, a few lesions of psoriasis vulgaris remained, although they were much less severe. Remission of acute arthropathy was impressive. Blood chemistry parameters were unchanged after therapy. Circadian levels of GH and EGF, normal before therapy, were significantly decreased after therapy. The infusion was well-tolerated. Infusion rates of greater than 250 micrograms/h caused only some complaints of abdominal pain, nausea, and vomiting. During the 4 years, erythrodermic symptoms reappeared only in seven patients, three of whom were also arthropathic. After 6-8 months, they underwent a second course of somatostatin therapy with good results. The other patients are still able to control their disease with tar-based products alone or with low-dose 8-methoxypsoralen + UVA (PUVA) or UV therapy. The arthropathic patients control their symptoms with periodic low-dose nonsteroidal antiinflammatory drug therapy.
在4年的时间里，对20名患有严重银屑病（红皮病型、亚红皮病型、难治性泛发型和/或与急性关节炎相关的类型）的患者进行了96小时的静脉持续输注生长抑素（施他宁，雪兰诺公司生产）治疗，生长抑素用5%葡萄糖注射液稀释，输注速度为250微克/小时。除了常规血液化学参数外，还在治疗前、治疗期间和治疗后测量了生长激素（GH）和表皮生长因子（EGF）的昼夜水平。治疗结束后约2至3周，红皮病型和亚红皮病型症状消失。在一些患者中，寻常型银屑病的一些皮损仍然存在，不过症状已轻得多。急性关节炎的缓解令人印象深刻。治疗后血液化学参数未发生变化。治疗前正常的GH和EGF昼夜水平在治疗后显著降低。输注耐受性良好。输注速度大于250微克/小时仅引起一些腹痛、恶心和呕吐的主诉。在这4年中，红皮病型症状仅在7名患者中复发，其中3名患者还患有关节炎。6至8个月后，他们接受了第二个疗程的生长抑素治疗，效果良好。其他患者仍然能够仅用焦油类产品或低剂量8-甲氧基补骨脂素+紫外线A（PUVA）或紫外线疗法控制病情。患有关节炎的患者通过定期低剂量非甾体抗炎药治疗来控制症状。
