肠易激综合征患者血浆及乙状结肠粘膜中VIP及SS的含量

探讨肠易激综合征(irritable bowel syndrome,IBS)患者血浆及乙状结肠粘肠中血管活性肠肽(VIP)及生长抑素(SS)有无变化,以及它们在IBS发病过程中的可能作用和临床意义.应用放射免疫分析法(RIA)测定IBS患者血浆及乙状结肠粘膜内VIP及SS的含量,并与正常组比较.结果是便秘型IBS患者血浆及乙状结肠粘膜中VIP含量显著高于正常组(P＜0.01),腹泻型显著低于正常组(P＜0.05);SS在IBS各组均显著高于正常组(P＜0.05),而便秘型又显著高于腹泻型(P＜0.05).IBS患者存在VIP及SS含量异常,且这些异常可能在IBS 发病中起一定的作用;不同类型IBS患者VIP及SS含量有显著差异,说明不同类型IBS在发病机制上可能有其不同的病理学基础.     

Metastatic pancreatic neuroendocrine tumor presenting as a pituitary space occupying lesion: a case report

Neuroendocrine tumor metastases to the pituitary gland are very rare. There are few case reports of carcinoid tumor metastases to the pituitary, but no cases of pancreatic neuroendocrine pituitary metastases have been reported. In this report we present a 55-year-old female with a sellar mass, ophthalmoplegia and headaches initially thought to represent an invasive null cell pituitary adenoma. However a histological (trans-sphenoidal and liver biopsies) and systemic investigation proved it to be a metastasis of an undiagnosed pancreatic neuroendocrine tumor. Our patient was unique in respect to the location of the metastasis and the uncharacteristically high proliferative index of her tumor. She received conventional therapy consisting of Sandostatin, chemotherapy and radiotherapy as well as labeled somatostatin following an avid uptake on octreotide scanning. Despite a radiological improvement the patient suffered progressive clinical deterioration and died.     

银屑病患者生长抑素的定量定位检测

目的 探讨生长抑素(somatostatin,SS)与银屑病的相关性.方法 用放射免疫分析法测定银屑病患者血浆及皮损中SS含量,用免疫组化法观察13例寻常型银屑病患者皮损和8例正常人皮肤中SS的分布,用原位杂交组织化学法检测皮损处SSmRNA表达情况.结果 定量检测表明患者血浆SS水平低于对照组,而患者皮损SS水平显着高于对照组,定位检测光镜下见3例新发银屑病患者皮损中的SS在真皮乳头层大片沉积,而10例慢性急性发作的病例与正常对照基本相同,光镜下见真皮层极散在分布的SS染色.对3例皮损中SS强阳性的银屑病患者,用原位杂交组织化学法检测皮损处SSmRNA表达情况,结果未见皮肤各层细胞内有SSmRNA表达信号.结论 银屑病患者SS血浆中的低水平及其皮损中的高表达提示SS在银屑病的发病中起重要作用.     

Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves’ disease, four Hashimoto’s thyroiditis, two isolated in appearance: Means’ syndrome). Each patient underwent hormonal (free T₃ and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and ¹¹¹In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of ¹¹¹In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution (χ² test, P<0.01). All ten patients in whom scintigraphy was considered positive were clinically improved at 6 months, and of the seven patients in whom scintigraphy was negative, six were not improved. Nevertheless, objective quantitative analysis did not succeed in confirming these results. We conclude that ¹¹¹In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed. Received 17 November 1998 and in revised form 13 January 1998     

生长抑素对人脐静脉张力的调节及其局部来源

目的　观察生长抑素（ＳＯＭ）是否和如何参与对人脐静脉（ＨＵＶ）张力的调节及是否存在ＨＵＶ 局部来源的ＳＯＭ。　方法　应用机械电换能器记录ＳＯＭ 对ＨＵＶ张力的影响及应用原位杂交（ＩＳＨ）技术观察体外培养人脐静脉内皮细胞（ＨＵＶＥＣ）是否表达ＳＯＭ 的ｍ ＲＮＡ。　结果　当存在ＨＵＶＥＣ时,ＳＯＭ 使ＨＵＶ明显舒张;不存在ＨＵＶＥＣ时,ＳＯＭ 并不使ＨＵＶ明显舒张。原位杂交显示体外培养ＨＵＶＥＣ出现ＳＯＭ ｍ ＲＮＡ的阳性信号,其阳性百分率受血管活性多肽（ＶＰｓ）的调节。　结论　ＨＵＶＥＣ具有合成ＳＯＭ 的能力并成为ＨＵＶ 局部ＳＯＭ 的一个重要来源,ＳＯＭ 参与了对ＨＵＶ 张力的局部调节作用（ＨＵＶＥＣ依赖性舒张ＨＵＶ）,并可能存在自身反馈机制。     

Central somatostatin: a re-examination of its effects on feeding

Previous investigations of centrally administered somatostatin (SRIF) have tended to employ pharmacological (nmol and greater) doses of the peptide. Under this protocol contradictory findings of feeding effects have been reported. There is evidence that the use of physiological doses can induce a completely distinct response from that obtained with pharmacological doses. In order to discern whether physiological doses of centrally administered somatostatin have any effect on feeding. SRIF in doses ranging from 0.4 pmol to 3 nmol were administered into the lateral ventricles of rats. Low pmol doses (0.4-40) administered during the light photoperiod increased 1 h feeding whereas 3 nmol decreased 1 h feeding. None of the doses tested during the dark photoperiod significantly altered 1 h food intake. Similarly, no significant change in 24-h food intake was observed following injections of any of the doses tested, whether in the light or dark. A dose of SRIF that increased feeding (1 pmol) did not significantly alter 1 h water intake when applied centrally in the light nor did it alter spontaneous locomotor activity. Furthermore, when applied peripherally it did not change 1 h food intake. These studies suggest that SRIF may work centrally to regulate food intake. A similarity exists between SRIF's feeding effects and the feeding effects we have previously described following central injections of growth hormone-releasing factor (GRF), both in terms of dose-response and photosensitivity. This suggests that these 2 peptides may act via a common mechanism to regulate food consumption; possibly in co-ordination with their regulation of growth hormone release. The possibility that such feeding regulation occurs as part of a short intrahypothalamic feedback loop is discussed.     

生长抑素联合白蛋白治疗急性胰腺炎患者的效果及对胰腺功能和免疫功能的影响

目的 观察生长抑素联合白蛋白治疗急性胰腺炎(acute pancreatitis,AP)患者的效果及对胰腺功能和免疫功能的影响.方法 回顾性分析采用生长抑素联合白蛋白治疗(观察组)及采用生长抑素治疗(对照组)的AP各38例的临床资料.观察比较两组临床症状消失时间,治疗后临床效果,治疗前后内皮功能、胰腺功能及免疫功能指标...     

肝硬化门脉高压症内科治疗的选择与评价

心得安推荐作为预防Child A或B级肝硬化患者中-重度静脉曲张初次出血;生长抑素及其类似物为急性食管胃底静脉曲张出血(EVB)的首选药物,控制出血疗效85%-90%;心得安或联合5-单硝异山梨醇、内镜下套扎或硬化剂可作为预防静脉曲张再出血的方法;经颈静脉肝内门腔分流术(TIPS)仅为Child B或C级患者准备肝脏移植的过度.内科联合治疗方法的评价需要循症医学的证据,轻度静脉曲张及早期门脉高压的治疗策略仍需要进一步研究.     

不同剂量生长抑素对肝硬化伴食管胃底静脉曲张GAS、HGB、GLC的影响

目的探讨不同剂量生长抑素对肝硬化伴食管胃底静脉曲张患者胃泌素(GAS)、血红蛋白(HGB)及胰高血糖素(GLC)的影响。方法收集2018年12月至2019年12月在本院治疗的106例肝硬化伴食管胃底静脉曲张患者的临床资料,根据药物使用剂量不同分为A组(53例,标准剂量生长抑素联合普萘洛尔治疗)和B组(53例,加倍剂量生长抑素联合普萘洛尔治疗)。对比两组患者治疗后临床疗效、治疗前后GAS、HGB、GLC水平、住院指标及血流动力学指标水平,观察2组患者治疗后不良反应发生情况。结果B组总有效率(90.57%)高于A组(71.70%),差异有统计学意义(P<0.05)。与治疗前比较,两组GAS、GLC明显下降,HGB明显升高,差异有统计意义(P<0.05);治疗后B组患者GAS、GLC低于A组,HGB高于A组,差异有统计学意义(P<0.05)。A组住院时间、止血时间均长于B组,输血量高于B组,差异有统计学意义(P<0.05)。与治疗前比较,两组患者CVP、PVP均明显下降,差异具有统计学意义(P<0.05);治疗后B组患者CVP、PVP明显低于A组,差异有统计学意义(P<0.05);两组治疗前后VPV水平相近,差异无统计学意义(P>0.05)。A组患者治疗后不良反应总发生率为5.66%明显低于B组16.98%,差异有统计学意义(P<0.05)。结论加倍剂量生长抑素联合普萘洛尔治疗临床疗效好,可有效改善患者GAS、HGB、GLC水平及血流动力学指标,并缩短患者住院时间、止血时间,安全性高,临床应用价值大。     

生长抑素引起低血糖症一例

本文通过对一例生长抑素引起低血糖症病例的分析,提示在临床应用生长抑素时,应加强对血糖的监测,避免不良反应的发生。