Growth Hormone Release Inhibiting Hormone in Acromegaly
Growth Hormone Release Inhibiting Hormone in Acromegaly
复制标题
肢端肥大症中的生长激素释放抑制激素
DOI：
10.1136/bmj.1.5904.352
复制
发表时间：
1974
影响因子：
--
通讯作者：
Reginald Hall
中科院分区：
文献类型：
--
作者：
G. Besser;C. Mortimer;D. Carr;A. V. Schally;D. H. Coy;D. Evered;A. Kastin;W. Tunbridge;M. Thorner;Reginald Hall
本文报告8例肢端肥大症患者接受不同剂量生长激素释放抑制激素（GHRIH）持续75分钟静脉滴注。100至1，000 μg在降低循环生长激素（GH）水平方面同样有效; 25 μg仅在5名患者中降低GH水平，并且在此剂量下下降的程度小于100 μg或更高剂量。10 μg无效。通过静脉、皮下和肌内途径注射500 μg单次剂量仅引起GH水平的微小和短暂降低，但肌内注射2 ml 16%明胶中的激素可改善效果。注射悬浮液4毫克GHRIH在1毫升花生油降低生长激素水平之间的三个和四个小时。在4名肢端肥大症患者中，在连续输注生理盐水或1，000 μg GHRIH期间进行口服50 g葡萄糖耐量试验。在这些患者中观察到的生理盐水输注期间生长激素的“矛盾”上升被GHRIH抑制。此外，血糖反应被GHRIH改变，在每种情况下，峰值延迟并发生在输注结束时。两名患者的“正常”葡萄糖耐量曲线转化为“糖尿病”型反应。这种作用可以通过已知大剂量GHRIH发生的胰岛素分泌抑制来解释。我们推测，肢端肥大症可能主要是一种下丘脑疾病，由于缺乏GHRIH导致生长激素从垂体和腺瘤形成过度分泌，由于不适当的和长期的刺激垂体。
Growth hormone release inhibiting hormone (GHRIH) was administered by constant infusion over 75 minutes to eight acromegalic patients at different doses. 100 to 1,000 μg were equally effective in reducing circulating growth hormone (GH) levels; 25 μg lowered GH levels in only five patients, and at this dose the extent of the fall was smaller than from doses of 100 μg or more. 10 μg was ineffective. Injection of single doses of 500 μg by intravenous, subcutaneous, and intramuscular routes caused only small and transient reductions in GH levels, though the effect was improved by injecting the hormone intramuscularly in 2 ml of 16% gelatin. Injection of a suspension of 4 mg GHRIH in 1 ml of arachis oil lowered growth hormone levels for between three and four hours. In four acromegalic patients an oral 50-g glucose tolerance test was performed during a continuous infusion of either saline or 1,000 μg GHRIH. The “paradoxical” rise in growth hormone seen in these patients during the saline infusion was suppressed by GHRIH. The blood glucose responses were, moreover, modified by GHRIH in that the peak was delayed and occurred at the end of the infusion in each case. A “normal” glucose tolerance curve was converted to a “diabetic” type of response in two patients. This effect could be accounted for by the inhibition of insulin secretion known to occur with large doses of GHRIH. We speculate that acromegaly may be primarily a hypothalmic disease due to deficiency of GHRIH resulting in excessive secretion of growth hormone from the pituitary and adenoma formation due to inappropriate and prolonged stimulation of the pituitary.