Lin H C, Tsai Y T, Huang C C, Meng H C, Lee F Y, Wang S S, Lee S D, Lo K J
Department of Medicine, Taipei Veterans General Hospital, Taiwan, Republic of China.
J Hepatol. 1994 Sep;21(3):424-9. doi: 10.1016/s0168-8278(05)80323-x.
The effects of octreotide on postprandial hemodynamic responses were evaluated in 20 patients with postnecrotic cirrhosis. They were randomly assigned to receive either a 100-micrograms bolus with a 100-micrograms/h infusion of octreotide or a placebo. Placebo administration did not affect any of the hemodynamic values. However, after a liquid meal of 500 kcal, postprandial increases in the hepatic venous pressure gradient and hepatic blood flow were observed in patients receiving placebo, while the systemic hemodynamic values remained unchanged. In contrast, in patients receiving octreotide, the hepatic blood flow was significantly decreased 30 min after administration, while the hepatic venous pressure gradient and the systemic hemodynamic values were not affected. After ingestion of a meal, the mean values of the hepatic blood flows were not significantly different from basal values. Moreover, the wedged hepatic venous pressure, the hepatic venous pressure gradient and the systemic hemodynamic values were not affected by meal ingestion. However, during octreotide infusion, hepatic blood flow 30 min after the meal had a tendency to increase compared to before the meal. In conclusion, octreotide inhibited the postprandial increase in portal pressure in patients with postnecrotic cirrhosis. In addition, octreotide decreased hepatic blood flow in the fasting state. When given before a meal, the increase in blood flow induced by the meal restored the hepatic blood flow to basal levels.
在20例坏死后肝硬化患者中评估了奥曲肽对餐后血流动力学反应的影响。他们被随机分配接受100微克奥曲肽推注并以100微克/小时的速度输注奥曲肽，或接受安慰剂。给予安慰剂不影响任何血流动力学值。然而，在摄入500千卡的流食后，接受安慰剂的患者观察到餐后肝静脉压力梯度和肝血流量增加，而全身血流动力学值保持不变。相比之下，接受奥曲肽的患者在给药后30分钟肝血流量显著降低，而肝静脉压力梯度和全身血流动力学值未受影响。进食后，肝血流量的平均值与基础值无显著差异。此外，肝楔压、肝静脉压力梯度和全身血流动力学值不受进食影响。然而，在输注奥曲肽期间，餐后30分钟的肝血流量与进食前相比有增加的趋势。总之，奥曲肽抑制了坏死后肝硬化患者餐后门静脉压力的升高。此外，奥曲肽在禁食状态下降低了肝血流量。餐前给药时，进食引起的血流增加将肝血流量恢复到基础水平。
