Hanew K, Utsumi A, Sugawara A, Shimizu Y, Ikeda H, Abe K
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
J Endocrinol Invest. 1994 May;17(5):313-21. doi: 10.1007/BF03348989.
To indirectly evaluate the hypothalamic somatostatin (SS) tone in patients with acromegaly, the effects of pyridostigmine (PD), a cholinesterase inhibitor which can inhibit hypothalamic SS secretion, on TRH-induced TSH secretion and the effects of SMS 201-995 on TSH or GH secretion were studied in acromegalic patients (31-69 yr, n = 10), normal young (21-24 yr, n = 7) and normal old male subjects (62-71 yr, n = 7). After pretreatment with PD (60 mg po, -30 min), normal young subjects showed significantly enhanced TSH responses to TRH (500 micrograms i.v., 0 min) compared to single administration of TRH, whereas normal old and acromegalic patients did not show such enhancement. Plasma TSH response to a single administration of TRH in acromegalic patients was significantly lower than that of normal young and old subjects. Although normal young and old subjects showed significantly enhanced GH responses to GHRH (100 micrograms i.v. at 0 min) after the pretreatment with PD (60 mg, -30 min), no such enhancement was observed in acromegalic patients. In contrast, the decrement in plasma TSH after SMS 201-995 administration was similar between normal subjects (5 young 5 old) and 7 acromegalic patients. Further, the maximal plasma GH decrement after administration was significantly greater in acromegalic patients than in the 5 normal young and 5 old subjects p < 0.01). In conclusion, hypothalamic SS tone does not appear to be elevated in acromegalic patients compared to normal young and probably old subjects.
为间接评估肢端肥大症患者下丘脑生长抑素（SS）的分泌状态，我们研究了胆碱酯酶抑制剂吡啶斯的明（PD）对促甲状腺激素释放激素（TRH）诱导的促甲状腺激素（TSH）分泌的影响（PD可抑制下丘脑SS分泌），以及SMS 201-995对肢端肥大症患者（年龄31 - 69岁，n = 10）、正常青年（年龄21 - 24岁，n = 7）和正常老年男性受试者（年龄62 - 71岁，n = 7）TSH或生长激素（GH）分泌的影响。在口服PD（60 mg，-30分钟）预处理后，与单独给予TRH相比，正常青年受试者对TRH（静脉注射500μg，0分钟）的TSH反应显著增强，而正常老年和肢端肥大症患者未出现这种增强。肢端肥大症患者单次给予TRH后的血浆TSH反应显著低于正常青年及老年受试者。虽然正常青年和老年受试者在口服PD（60 mg，-30分钟）预处理后对生长激素释放激素（GHRH，静脉注射100μg，0分钟）的GH反应显著增强，但肢端肥大症患者未观察到这种增强。相反，正常受试者（5名青年和5名老年）和7名肢端肥大症患者在给予SMS 201-995后血浆TSH的下降情况相似。此外，肢端肥大症患者给药后血浆GH的最大下降幅度显著大于5名正常青年和5名正常老年受试者（p < 0.01）。总之，与正常青年以及可能的老年受试者相比，肢端肥大症患者下丘脑SS的分泌状态似乎并未升高。
