Döbrönte Z, Juhász L, Tulassay Z
Vas Megyei Markusovszky Kórház II. Belgyógyászati Osztály, Szombathely.
Orv Hetil. 1996 Oct 20;137(42):2309-12.
The aim of the multicentric trial was to study the effect of octreotide (Sandostatin) on the rise of pancreatic amylase in the serum after ERCP based on a large number of patients. The study was carried out in a prospective random manner in 2102 patients in 11 endoscopic centers. Patients in the treated group received 0.1 mg octreotide acetate, and those of the nontreated (control) group received isotonic sodium-chloride subcutaneously before the ERCP and 45 minutes after. Serum amylase and blood sugar were checked before the endoscopic procedure, 6 and 24 hours later. Out of the total number of patients involved, data of 1199 patients (599 in the treated group, and 600 in the control group) were evaluated. Octreotide diminished the percentual increase of serum amylase levels following ERCP. However, the frequency of hyperamylasaemia was decreased only after in patients with chronic obstructive pancreatitis or in such patients after endoscopic sphincterotomy. The peak serum level of blood sugar was higher in the treated group compared to the controls. There was no difference in the clinical symptoms following ERCP between the two groups.
the prophylactic use of long-acting somatostatin may diminish the frequency of hyperamylasemia after ERCP in patients with chronic obstructive pancreatitis or in those patients who subsequently underwent EST.
这项多中心试验的目的是基于大量患者研究奥曲肽（善宁）对内镜逆行胰胆管造影术（ERCP）后血清中胰腺淀粉酶升高的影响。该研究在11个内镜中心对2102例患者进行了前瞻性随机研究。治疗组患者在ERCP前及术后45分钟皮下注射0.1毫克醋酸奥曲肽，未治疗（对照）组患者注射等渗氯化钠。在内镜检查前、6小时和24小时后检查血清淀粉酶和血糖。在所有参与患者中，对1199例患者（治疗组599例，对照组600例）的数据进行了评估。奥曲肽降低了ERCP后血清淀粉酶水平的百分比升高。然而，仅在慢性阻塞性胰腺炎患者或内镜括约肌切开术后患者中，高淀粉酶血症的发生率才降低。治疗组的血糖峰值血清水平高于对照组。两组在ERCP后的临床症状方面没有差异。
长效生长抑素的预防性使用可能会降低慢性阻塞性胰腺炎患者或随后接受内镜括约肌切开术的患者ERCP后高淀粉酶血症的发生率。
