Jones S L, Patchett S, Anderson J V, Farthing M J, Besser G M, Wass J A
Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London, UK.
Clin Endocrinol (Oxf). 1995 Dec;43(6):683-7. doi: 10.1111/j.1365-2265.1995.tb00535.x.
Octreotide, a synthetic long-acting analogue of somatostatin, now has an established role in the treatment of acromegaly. In acromegalic patients treated with octreotide there is an increased incidence of gallstones and possibly gastritis.
(1) To compare the seroprevalence of Helicobacter pylori (H. pylori) infection, in acromegalic patients treated with octreotide to that in patients given other treatment modalities. (2) To study retrospectively the temporal relation between H. pylori acquisition and octreotide treatment.
Three groups of acromegalic patients were studied; 35 (20 M) had been treated with octreotide, 17 (10 M) with bromocriptine and 19 (12 M) had received no pharmacological intervention (untreated, surgically treated or treated with radiotherapy).
DESIGN/MEASUREMENTS: The presence of H. pylori infection was assessed serologically (Bio-Rad GAP test for IgG), using stored serum, on the most recent sample from each patient and on serial samples from patients treated with octreotide.
The prevalence of H. pylori seropositivity was similar in each treatment group, 34, 35 and 37%, respectively. Mean age and duration of acromegaly were similar in the first two groups. Patients who had never received medical treatment were slightly younger. GH levels were similar in all three groups. Patients on octreotide who were seropositive for H. pylori did not differ from those with negative serology with respect to age, duration of acromegaly, duration of octreotide treatment or serum GH level. Serial samples in octreotide treated patients showed a change in status in only one patient; 18 patients continued with negative serology during a mean period of 30 (range 4-62) months. In each of the 6 patients with persistently positive serology during octreotide treatment, stored samples predating octreotide therapy were shown to have already been positive.
The seroprevalence of H. pylori infection in acromegalic patients does not appear to be increased in a manner dependent on the type or duration of medical treatment. In particular, octreotide therapy, while causing the development of histological gastritis in some patients, does not appear to induce the development of H. pylori infection.
奥曲肽是一种合成的长效生长抑素类似物，目前在肢端肥大症的治疗中已确立了其作用。在用奥曲肽治疗的肢端肥大症患者中，胆结石和可能的胃炎发病率增加。
（1）比较接受奥曲肽治疗的肢端肥大症患者与接受其他治疗方式的患者中幽门螺杆菌（H. pylori）感染的血清流行率。（2）回顾性研究幽门螺杆菌感染与奥曲肽治疗之间的时间关系。
研究了三组肢端肥大症患者；35例（20例男性）接受了奥曲肽治疗，17例（10例男性）接受了溴隐亭治疗，19例（12例男性）未接受任何药物干预（未治疗、手术治疗或放射治疗）。
设计/测量：使用储存的血清，通过血清学方法（Bio-Rad IgG GAP检测）评估每位患者最近一份样本以及接受奥曲肽治疗患者的系列样本中是否存在幽门螺杆菌感染。
每个治疗组中幽门螺杆菌血清阳性率相似，分别为34%、35%和37%。前两组患者的平均年龄和肢端肥大症病程相似。从未接受过药物治疗的患者年龄稍小。三组患者的生长激素水平相似。奥曲肽治疗的患者中，幽门螺杆菌血清阳性者在年龄、肢端肥大症病程、奥曲肽治疗时间或血清生长激素水平方面与血清学阴性者无差异。奥曲肽治疗患者的系列样本中，仅1例患者的状态发生了变化；18例患者在平均30个月（范围4 - 62个月）期间血清学持续为阴性。在奥曲肽治疗期间血清学持续阳性的6例患者中，奥曲肽治疗前储存的样本显示已经呈阳性。
肢端肥大症患者中幽门螺杆菌感染的血清流行率似乎不会因药物治疗的类型或持续时间而以某种方式增加。特别是，奥曲肽治疗虽然在一些患者中会导致组织学胃炎的发生，但似乎不会诱发幽门螺杆菌感染的发生。
