Minniti G, Jaffrain-Rea M L, Baldelli R, Ferretti E, Caracciolo B, Bultrini A, Gulino A, Tamburrano G
Endocrinologia I-II Clinica Medica, Università di Roma, La Sapienza, Italy.
Clin Ter. 1997 Dec;148(12):601-7.
The acute GH lowering effects of a single dose of either octreotide (OCT) or cabergoline (CAB), given alone and in combination, were studied in a series of 21 patients with acromegaly.
Plasma GH was measured for 8 hours after a single subcutaneous injection of OCT (100 micrograms) and for 48 hours after a single oral dose of CAB (0.5 mg) in all patients. Fourteen patients, who did not suppress GH levels below 5 micrograms/L after either OCT or CAB given alone, also received a combination of both drugs (OCT 100 micrograms s.c. + CAB 0.5 mg p.o. 24 h before OCT).
GH levels were acutely suppressed by more than 50% in 15/21 cases after OCT alone and in 5/21 after CAB alone, respectively (P < 0.01). In the 14 patients who received the combined test, the magnitude of GH suppression was significantly higher than after OCT alone 4, 6 and 8 hours after OCT administration (P < 0.02). In patients with mixed GH/PRL-secreting tumors, the additive effect of OCT and CAB was observed at each time point.
These results suggest that combined therapy with OCT and CAB may be more effective in suppressing GH secretion than either compound given alone, especially in patients with GH/PRL-secreting adenomas.
在21例肢端肥大症患者中，研究单独及联合使用单剂量奥曲肽（OCT）或卡麦角林（CAB）对生长激素（GH）的急性降低作用。
所有患者单次皮下注射奥曲肽（100微克）后8小时及单次口服卡麦角林（0.5毫克）后48小时测量血浆GH水平。14例单独使用奥曲肽或卡麦角林后GH水平未抑制至5微克/升以下的患者，还接受了两种药物的联合治疗（在注射奥曲肽前24小时皮下注射奥曲肽100微克 + 口服卡麦角林0.5毫克）。
单独使用奥曲肽后，15/21例患者的GH水平急性抑制超过50%，单独使用卡麦角林后为5/21例（P < 0.01）。在接受联合检测的14例患者中，奥曲肽给药后4、6和8小时，GH抑制程度显著高于单独使用奥曲肽时（P < 0.02）。在生长激素/泌乳素混合分泌型肿瘤患者中，每个时间点均观察到奥曲肽和卡麦角林的相加作用。
这些结果表明，奥曲肽和卡麦角林联合治疗在抑制GH分泌方面可能比单独使用任一药物更有效，尤其是在生长激素/泌乳素分泌型腺瘤患者中。
