Cuttica C M, Fazzuoli L, Cariola G, Carraro A, Porcella E, Giusti M, Giordano G
DISEM, Cattedra di Endocrinologia, Università, Genova.
Recenti Prog Med. 1994 Jan;85(1):7-12.
Octreotide, as well as endogenous somatostatin, inhibits GH and TSH secretion. The drug is employed in the medical therapy of acromegaly. We studied the effects of a long-term (1-120 months; median 12 months) therapy with octreotide (300 micrograms/day) given in 3-times intermittent s.c. administration or in pulsatile s.c. (25 micrograms/120 min) way, upon the pituitary-thyroid axis. Thirteen patients (11 with normal thyroid function, 1 with secondary hypothyroidism, 1 with toxic goiter) with active acromegaly were studied. In the euthyroid patients no significative variations in both TSH levels and thyroid hormones were found during octreotide therapy. In the non-euthyroid patients octreotide did not induce changes in the dosages of drugs acting to thyroid function. The 24-hour IC-TSH levels did not show any variation during octreotide. TSH response to TRH was reduced (P < 0.05) during octreotide therapy. No correlation among TSH, IGF-I and GH levels was observed. Long-term treatment of acromegaly with octreotide reduces TSH response to TRH but do not interfere with both 24-hour IC-TSH levels and thyroid function.
奥曲肽以及内源性生长抑素可抑制生长激素(GH)和促甲状腺激素(TSH)的分泌。该药物用于肢端肥大症的医学治疗。我们研究了奥曲肽(300微克/天)以3次间歇性皮下注射或脉冲式皮下注射(25微克/120分钟)的方式进行长期(1 - 120个月;中位数为12个月)治疗对垂体 - 甲状腺轴的影响。对13例活动性肢端肥大症患者(11例甲状腺功能正常,1例继发性甲状腺功能减退,1例毒性甲状腺肿)进行了研究。在甲状腺功能正常的患者中,奥曲肽治疗期间TSH水平和甲状腺激素均未发现明显变化。在非甲状腺功能正常的患者中,奥曲肽未引起作用于甲状腺功能的药物剂量变化。奥曲肽治疗期间24小时免疫化学发光法检测的TSH(IC - TSH)水平未显示任何变化。奥曲肽治疗期间TSH对促甲状腺激素释放激素(TRH)的反应降低(P < 0.05)。未观察到TSH、胰岛素样生长因子 - I(IGF - I)和GH水平之间的相关性。奥曲肽长期治疗肢端肥大症可降低TSH对TRH的反应,但不影响24小时IC - TSH水平和甲状腺功能。