Andersen M, Hansen T B, Bollerslev J, Bjerre P, Schrøder H D, Hagen C
Department of Medical Endocrinology, Odense University Hospital, Denmark.
J Endocrinol Invest. 1995 Dec;18(11):840-6. doi: 10.1007/BF03349830.
We aimed to test the hypothesis, that octreotide has a suppressive effect on unstimulated and TRH-stimulated PRL levels in both normo- and hyperprolactinaemic acromegalic patients, and besides to evaluate the effect of octreotide on unstimulated TSH and thyroid hormones. The present study is a doubleblind placebo-controlled cross-over trial; the 12 acromegalic patients were treated with octreotide or placebo (300 micrograms/d) for 4 weeks separated by a 12 weeks washout period. Before and after each 4 weeks period a TRH-test (200 micrograms iv) was performed and serum GH and PRL levels were determined. Serum TSH and thyroid hormones were determined after 0, 2, 3, and 4 weeks. In the whole group unstimulated PRL levels were 18 micrograms/l +/- 5 before and 7 micrograms/l +/- 1 during octreotide treatment (p < 0.01). The PRL lowering effect of octreotide was significantly more pronounced in hyperprolactinemic patients compared to normoprolactinaemic patients (p < 0.05). Patients with the highest pretreatment PRL levels had the most pronounced percentage suppression of unstimulated PRL levels during octreotide treatment. Eight out of 12 patients had a TRH-stimulated PRL response > or = 100%, both during placebo and octreotide treatment, but in the group as a whole maximal TRH-stimulated PRL levels were suppressed during octreotide treatment, PRL levels were 50 micrograms/l +/- 20 before and 18 micrograms/l +/- 3 during octreotide treatment (p < 0.05). Unstimulated GH levels were 48 mU/l +/- 15 before and 13 mU/l +/- 2 during octreotide treatment (p < 0.01). Serum total T3 was significantly reduced during octreotide treatment (p < 0.05); serum TSH, total T4 or free T4 index were not significantly changed during treatment. We conclude that patients with acromegaly and hyperprolactinemia will normalize PRL levels during 4 weeks of octreotide treatment and octreotide will reduce total T3 levels in acromegalic patients.
奥曲肽对正常泌乳素血症和高泌乳素血症的肢端肥大症患者的基础及促甲状腺激素释放激素（TRH）刺激后的泌乳素（PRL）水平均有抑制作用，此外，还要评估奥曲肽对基础促甲状腺激素（TSH）和甲状腺激素的影响。本研究是一项双盲安慰剂对照交叉试验；12例肢端肥大症患者分别接受奥曲肽或安慰剂（300微克/天）治疗4周，中间间隔12周的洗脱期。在每4周治疗期前后进行一次TRH试验（静脉注射200微克），并测定血清生长激素（GH）和PRL水平。在0、2、3和4周时测定血清TSH和甲状腺激素。在整个研究组中，基础PRL水平在治疗前为18微克/升±5，奥曲肽治疗期间为7微克/升±1（p<0.01）。与正常泌乳素血症患者相比，奥曲肽降低PRL水平的作用在高泌乳素血症患者中更为显著（p<0.05）。治疗前PRL水平最高的患者在奥曲肽治疗期间基础PRL水平的抑制百分比最为显著。12例患者中有8例在安慰剂和奥曲肽治疗期间TRH刺激后的PRL反应≥100%，但作为一个整体，在奥曲肽治疗期间TRH刺激后的PRL最高水平受到抑制，PRL水平在治疗前为50微克/升±20，奥曲肽治疗期间为18微克/升±3（p<0.05）。基础GH水平在治疗前为48毫单位/升±15，奥曲肽治疗期间为13毫单位/升±2（p<0.01）。奥曲肽治疗期间血清总T3显著降低（p<0.05）；治疗期间血清TSH、总T4或游离T4指数无显著变化。我们得出结论，肢端肥大症和高泌乳素血症患者在奥曲肽治疗4周后PRL水平将恢复正常，且奥曲肽会降低肢端肥大症患者的总T3水平。
