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奥曲肽治疗消化系内分泌肿瘤进展_医学论文 | |||||
作者:网络 论文来源:网络 点击数:668 更新时间:2007/4/11 | |||||
奥曲肽(Octreotide)是一种长效生长抑素(Somatostatin. SS)的类似物,商品名善得定(Sandostatin)。其分子结构为一环形肽,具有活性的四个氨基酸排列顺序与SS相同,故可与广泛存在于中枢神经系统、垂体和胰腺β细胞等处的SS受体结合产生生物学效应。奥曲肽的生物学活性明显强于SS,其抑制生长激素(GH)、胰岛素、胰高糖素、胃泌素及胃酸分泌等作用均强于SS,特异性也较高,同时由于结构较稳定不易为酶降解,其半减期延长至80~160min。目前奥曲肽主要应用于消化道疾病和多种内分泌肿瘤的治疗。临床试用发现奥曲肽对胃泌素瘤、血管活性肠肽(VIP)瘤、类癌综合征、胰岛素瘤、生长激素释放激素瘤、胰高糖素瘤、胰源性异位Cushing’s综合征等多种消化道内分泌肿瘤均可控制症状,部分病人肿瘤生长亦可受控制。笔者就其在治疗消化系内分泌肿瘤的应用进展作一综述。 1 胃泌素瘤 2 血管活性肠肽瘤 3 类癌综合征 4 胰岛素瘤 5 生长激素释放激素(GHRH)瘤 6 胰高糖素瘤 7 胰源性异位Cushing’s综合征 8 副作用 9 小结 参考文献 1 Ruszniewski P, Laucournet H, Mignon M, et al. Long-acting somatostatin(SMS 201-955) in the management of Zollinger-Ellison syndrome: evidence for Sustained efficacy. Pancreas,1988;3(2):145 2 Vinik AL, Lloyd R, Cho K. The use of somatostatin analog in gastroenteropancreatic tumors other than carcinoid. Metabolism,1990;39(9 suppl):156 3 Mozell EJ, Katz MD, Baxter JN, et al. Long-term efficacy of octreotide in the treatment of Zollinger-Ellison Syndrome. Arch Surg,1992;127:1019 4 Fluckiger A. Long-term therapy of a metastasizing pancreatic vipoma using the somatostatin derivative octreotide. Schwei Med Wochenschr,1992;122:1221 5 Maton PN, Hanks JB, Jekins SA, et al. Use of gut peptide receptor agonists and antagonists in gastrointestinal disease. Gastroentreol Clin North Am,1992;21:551 6 Kvols LK, Becher V, Steer ML. Treatment of the malignant carcinoidSyndrome. NEJM,1986;315:663 7 Kvols LK. Therapeutic considerations for malignant carcinoid syndrome. Acta Oncol,1989;28(3):433 8 Yinik A, Binder M, Choil TK, et al. Treatment of the carcinoid syndrome with the somatostatin analogue. Dig Dis Sci,1989;34(1):14 9 Joensum H, Burroughs AK. Dramatic response of a metastatic careimoid tumor to a comibnation of interferon and octreotide. Acta EndocrinolCopenh,1992;126:184 10 Glaser B, Rosler A, Halperin Y. Chronic treatment of a benign insulinoma using the longacting somatostatin analogue SMS 201-955. Isr J Med Sci,1990;26(1):16 11 Verschoor L, Uitterlinden P, Lamberts SW, et al. On the use of a new somatostatin analogue in the treatment of hypoglycaemia in patientswith insulinoma. Chin Endocrinool,1986;25(5):555 12 Vance ML. Long-term treatment of 18 acromegalic patients with thesomatostatin analog octreotide. Arch Intern Med,1991;151:1573 13 Eijeck CHJ. Somatostatin receptor-dependent growth inhibition ofliver metastases by octreotide. Br J Surg,1994;81(9):1333 14 Maton PN, Kussin P. The use of the long-acting somatostatin analogue, octreotide acetate. in patients with islet cell tumors. Gastroenterol Clin North Am,1989;18:897 15 Lorcy Y, Derennes V, Delanbre C, et al. Remission of recurrent Cushing’s disease with an analog of somatostatin(letter). Presse Med,1988;17:1217 16 Zhu X F, Melmed S, Torres AJ, et al. Effect of small doses of somatostatin analog. octreotide, on gallbladder contractility in normal chinese adults. Dig Dis Sci,1992;37(1):105 |
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