奥曲肽对氧诱导视网膜新生血管抑制作用的研究
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醋酸奥曲肽注射液以下内容仅供参考,请以药品包装盒中的说明书为准。
妊娠:B哺乳:L3醋酸奥曲肽注射液说明书【说明书修订日期】核准日期:2006年10月11日修订日期:2007年12月24日修订日期:2014年12月03日【药品名称】醋酸奥曲肽注射液【英文名称】OctreotideAcetate Injection【汉语拼音】Cusuan Aoqutai Zhusheye【成份】本品活性成分为醋酸奥曲肽。
辅料为:乳酸、甘露醇、碳酸氢钠、注射用水。
【性状】本品为无色的澄明液体。
【适应症】控制手术治疗或放射治疗不能充分控制病情的肢端肥大症患者的症状并降低患者的生长激素(GH)和胰岛素样生长因子-1(IGF-1)血浆水平。
善宁也可治疗不能或不愿手术的肢端肥大症患者,或者治疗放射治疗尚未生效的间歇期肢端肥大症患者。
缓解与功能性胃肠胰腺(GEP)内分泌肿瘤有关的症状,如具有类癌综合征表现的类癌瘤。
善宁不是抗癌药,不能治愈这些患者。
预防胰腺手术后并发症。
肝硬化患者胃-食管静脉曲张所致出血的紧急治疗,止血和预防再出血,善宁应与内窥镜硬化剂等特殊治疗联用。
【规格】1ml:0.1mg(以C49H66N10O10S2计)【用法用量】肢端肥大症开始每8小时或12小时皮下注射一次,每次0.05~0.1毫克,然后每月依循环GH、IGF-1水平和临床反应及耐受性做相应调整(目标:GH小于2.5纳克/毫升;IGF正常范围)。
多数病人每日最适剂量为0.2~0.3毫克。
对长期接受同一剂量治疗的病人每6个月测定一次GH浓度。
每日不得超过1.5毫克的最大剂量,通过监测血浆GH水平,治疗数月后可酌情减量。
如果用药1个月内仍无GH水平的降低和无临床反应,应考虑停药。
胃肠胰内分泌肿瘤最初皮下注射每日一到两次,每次0.05毫克,根据临床反应和肿瘤分泌的激素浓度(在类癌的情况下,根据5-羟吲哚乙酸的尿液排泄量)以及耐受性,渐增至每次0.1~0.2毫克,每日三次。
·83JOURNAL OF RARE AND UNCOMMON DISEASES, JAN. 2024,Vol.31, No.1, Total No.174【第一作者】孙江霞,女,主治医师,主要研究方向:内科。
E-mail:*******************【通讯作者】孙江霞·论著·生长抑素联合奥曲肽对肝硬化并发上消化道出血患者止血效果及血清学指标的影响*孙江霞*新乡市传染病医院内科(河南 新乡 453000)【摘要】目的 探讨生长抑素联合奥曲肽对肝硬化并发上消化道出血患者止血效果及血清学指标的影响。
方法 选取2018年2月至2023年2月新乡市传染病医院收治的肝硬化合并上消化道出血患者48例,将其分为联合生长抑素组与奥曲肽组(方法为随机数字表法),两组各24例。
奥曲肽组在常规治疗基础上给予奥曲肽治疗,联合生长抑素组奥曲肽组基础上联合生长抑素治疗,两组均持续治疗5 d,观察并比较两组临床疗效、血清学指标、肝功能指标及不良反应发生率。
结果 联合生长抑素组止血时间、住院时间短于奥曲肽组,输血量少于奥曲肽组,72 h再出血发生率低于奥曲肽组;与治疗前相比,治疗72 h后两组血清LHP、MAD、AOPP及血氨水平均下降,联合生长抑素组低于奥曲肽组;治疗72 h后两组血清GSH-Px及胆碱酯酶水平均上升,联合生长抑素组高于奥曲肽组;治疗72 h后奥曲肽组TBIL水平升高;P <0.05表示差异有显著意义。
结论 肝硬化并发上消化道出血患者应用生长抑素联合奥曲肽可优化止血效果,改善血清学指标,降低机体氧化应激反应,降低肝功能损伤,具备较高安全性。
【关键词】肝硬化;上消化道出血;生长抑素;奥曲肽;氧化应激;肝功能【中图分类号】R657.3+1 【文献标识码】A【基金项目】河南省职业教育和继续教育精品在线开放课程(教办职成〔2022〕360 号——160号) DOI:10.3969/j.issn.1009-3257.2024.1.034Effect of Somatostatin Combined with Octreotide on Hemostasis and Serological Indexes in Patients with Liver Cirrhosis Complicated with Upper Gastrointestinal Bleeding*SUN Jiang-xia *.Department of medicine, Xinxiang Infectious Diseases Hospital, Xinxiang 453000, Henan Province, ChinaAbstract: Objective To explore the hemostatic effect of somatostatin combined with octreotide on patients with liver cirrhosis complicated with uppergastrointestinal bleeding and the influence of serological indexes. Methods From February 2018 to February 2023, 48 patients with liver cirrhosis complicated with upper gastrointestinal bleeding in Xinxiang Infectious Disease Hospital were selected and they were divided into the combined somatostatin group and the octreotide group (random number table method), with 24 cases in each group. The octreotide group was treated with octreotide on the basis of routine treatment, and the combined somatostatin group was treated with somatostatin on the basis of octreotide group. Both groups continued to be treated for 5 d. The clinical efficacy, serological indicators, liver function indicators and the incidence of adverse reactions between the two groups were observed and compared. Results The hemostasis time, hospitalization time, blood transfusion amount and rebleeding rate of the combined somatostatin group were shorter than those of the octreotide group. Compared with before treatment, after 72 h treatment, the serum LHP , MAD, AOPP and blood ammonia of the two groups decreased on average, and the combined somatostatin group was lower than the octreotide group. The serum GSH-Px and cholinesterase levels of the two groups increased after treatment for 72 h, and the combined somatostatin group was higher than the octreotide group. The level of TBIL of the octreotide group increased after treatment for 72 h; P <0.05 indicates that the differences were significant. Conclusion Somatostatin combined with octreotide could optimize the hemostasis effect in patients with liver cirrhosis complicated with upper gastrointestinal bleeding, improve serological indexes, reduce the oxidative stress reaction of the body, and reduce the damage of liver function, with high safety.Keywords: Liver Cirrhosis; Upper Gastrointestinal Bleeding; Somatostatin; Octreotide; Oxidative Stress; Liver Function 肝硬化可导致患者食管胃底静脉曲张破裂,主要原因为过重的肝脏负荷引起门脉压力增高,可进一步引发上消化道出血,是肝硬化患者较为严重的并发症类型之一,也是导致其死亡的主要原因之一[1-2]。
・论著・基金项目:国家杰出青年科学基金(39725012)作者单位:400016,重庆,重庆医科大学消化疾病研究室通讯作者:唐承薇400016,重庆,重庆医科大学第一医院消化内科奥曲肽抑制肝癌生长的实验研究王春晖 唐承薇 汤丽平 【摘要】 目的 研究生长抑素类似物奥曲肽在体外、体内对肝癌生长及凋亡的影响。
方法 采用3H 2胸腺嘧啶核苷(3H 2TdR )掺入法、DNA 末端原位标记染色(T UNE L )及流式细胞技术检测奥曲肽对体外培养的肝癌细胞生长影响及凋亡的诱导作用。
利用S M MC 27721肝癌细胞株建立裸鼠肝癌原位种植瘤模型,实验组皮下注射奥曲肽100μg ・kg -1・d -1;对照组予生理盐水20μl ・d -1;共给药8周。
结果 培养细胞经不同浓度的奥曲肽作用48h 后,对肝癌细胞的生长具有明显的抑制作用,且肝癌细胞3H 2TdR 掺入值与奥曲肽的浓度呈负相关(r =-0.97,P <0.01)。
T UNU L 显示,1×10-6m ol/L 的奥曲肽作用24h 后,肝癌细胞凋亡率为15.2%±2.4%;流式细胞检测可见明显的凋亡峰。
奥曲肽治疗组裸鼠肝癌原位种植瘤重量明显低于对照组(0.27±0.05vs 0.85±0.37,P <0.01)。
结论 体内及体外实验表明,奥曲肽能有效抑制肝癌生长,其机制可能与抑制肝癌细胞DNA 合成及诱导肝癌细胞凋亡有关。
【关键词】 癌,肝细胞; 奥曲肽; 脱噬作用I nhibition effects of octreotide on the grow th of hep atocellular carcinom a in vitro and in vivo WANG Chunhui,T ANG Chengwei ,T ANG Liping.Department o f Gastroenterology ,The Fir st Hospital ,ChongqingUniver sity o f Medical Sciences ,Chongqing ,400016China【Abstract 】 Objective T o investigate the effects of s omatostatin analogue octreotide on the proliferation and apoptosis of human hepatocellular carcinoma (HCC )cell line as well as the growth of HCC xenografts in nude mice.Methods The effects of octreotide on the proliferation and apoptosis of S M MC 27721HCC cells wasmeasured by 3H 2thymidine incorporation into DNA and the TdT 2mediated dUTP nick end labeling assay (T UNE L )or flow cytometric assay separately.Nude mice bearing xenografts of the cell line were treated with octreotide or saline as a control daily until eight weeks after tum or implantation.R esults Incubation withoctreotide decreased 3H 2thymidine incorporation into DNA of S M MC 27721cells by ~50%at a concentration of 1μm ol/L.The inhibit effect of octreotide showed a concentration dependence.A fter 96h incubation ,total cell count was decreased 52.2%compared with control.When cells were treated by octreotide at 1×1026m ol/L for 24hours ,the apoptosis rates was (15.2±2.4)%.At necropsy ,in mice given octreotide ,the mean tum or weight were significantly lower than that of control group (0.27±0.05vs 0.85±0.37,P <0.01).The inhibition rate of tum or in viv o at 2m onths was 68.2%.Conclusion Octreotide is effective in inhibiting growth of HCC both in vivo and in vitro significantly.The mechanisms of antineoplastic effect action may inv olved in inhibiting DNA synthesize and inducing apoptosis of tum or cells.【K ey w ords 】 Carcinoma ,hepatocellular ; Octreotide ; Apoptosis 肝细胞肝癌(hepatocellular carcinoma ,HCC )是消化系统常见的肿瘤,对根治无望的肝癌患者,目前尚缺乏有效的治疗手段。