EFFECTS OF BOLUS INJECTIONS AND CONTINUOUS INFUSIONS OF SOMATOSTATIN AND PLACEBO IN PATIENTS WITH CIRRHOSIS - A DOUBLE-BLIND HEMODYNAMIC INVESTIGATION
EFFECTS OF BOLUS INJECTIONS AND CONTINUOUS INFUSIONS OF SOMATOSTATIN AND PLACEBO IN PATIENTS WITH CIRRHOSIS - A DOUBLE-BLIND HEMODYNAMIC INVESTIGATION
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DOI：
10.1002/hep.1840220117
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发表时间：
1995-07-01
期刊：
影响因子：
13.5
通讯作者：
RODES, J
中科院分区：
文献类型：
--
作者：
CIRERA, I;FEU, F;RODES, J
本双盲研究旨在探讨生长抑素或安慰剂对肝硬化患者血液动力学和体液的影响。患者被随机分配接受注射250 μ g生长抑素，然后以250 μ g/h的速度持续输注生长抑素（n = 13），注射250 μ g生长抑素，然后以500 μ g/h的速度持续输注（n = 10），或注射安慰剂，然后再输注安慰剂（n = 9）。安慰剂没有效果。躯体他汀丸显著降低肝静脉压梯度：1分钟降低52%；P < .001；3分钟19%，P < 0.01；5分钟时下降13%，P < .04。奇侧血流量在1分钟同样减少45%，P < 0.001；3分钟16%，P < .02；5分钟为9.5%,P = 0.05。平均动脉压升高25% （P < 0.001）。连续输注生长抑素（250或500 μ g/h）对全身无影响，但显著降低肝静脉压梯度（250 μ g/h: -6.1%, P < 0.05和500 μ g/h: -15%， P < 0.01）和肝血流量（250 μ g/h: -10%, 500 μ g/h: -18%, P < 0.05）。注射250 μ g/h后奇静脉血流无变化，500 μ g/h后奇静脉血流减少（-23%,P < 0.02）。生长抑素而不是安慰剂，将胰高血糖素抑制到正常水平。本研究表明，大剂量注射生长抑素可立即显著降低肝静脉压梯度和奇静脉血流量。持续输注生长抑素对内脏血流动力学有轻微但持续的影响；剂量越高，效果越明显。
The present double-blind study was aimed at investigating the hemodynamic and humoral effects of somatostatin or placebo in patients with cirrhosis. Patients were randomly assigned to receive either an injection of 250 mu g of somatostatin followed by a constant infusion of somatostatin at 250 mu g/h (n = 13), an injection of 250 mu g of somatostatin followed by a 500 mu g/h continuous infusion (n = 10), or an injection of placebo followed by a placebo infusion (n = 9). Placebo had no effect. Somato statin bolus markedly decreased the hepatic venous pressure gradient: by 52% at 1 minute; P < .001; 19% at 3 minutes, P < .01; and by 13% at 5 minutes, P < .04. Azygos blood flow decreased similarly by 45% at 1 minute, P < .001; 16% at 3 minutes, P < .02; and 9.5% at 5 minutes, P = .05. Mean arterial pressure increased by 25% (P < .001). Continuous somatostatin infusions (250 or 500 mu g/h) had no systemic effects, but significantly reduced hepatic venous pressure gradient (250 mu g/h: -6.1%, P < .05 and 500 mu g/h: -15%, P < .01) and hepatic blood flow (250 mu g/h: -10%, 500 mu g/h: -18%, P < .05). Azygos blood flow was not changed after 250 mu g/h infusion but was reduced after 500 mu g/h (-23%, P < .02). Somatostatin but not placebo, suppressed glucagon to normal levels. This study shows that a bolus injection of somatostatin caused an immediate and marked decrease of hepatic venous pressure gradient and azygos blood flow. Continuous infusion of somatostatin had a mild but sustained effect on splanchnic hemodynamics; this effect was more pronounced with the higher dose.