Document Detail


Effect of somatostatin versus octreotide on portal haemodynamics in patients with cirrhosis and portal hypertension.
MedLine Citation:
PMID:  15647641     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Elevated portal inflow is part of the pathogenesis of portal hypertension in patients with cirrhosis. Vasoactive substances appear to play a primary role in the regulation of portal flow. The aim of this study was to investigate the effects of somatostatin and octreotide on portal pressure and plasma levels of insulin-like growth factor (IGF-1), nitric oxide (NO), endothelin-1 (ET-1) and glucagon (GLU). METHODS: Portal pressures of 14 cirrhotic patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) were directly measured via a catheter placed in the portal vein. Portal pressure and IGF-1, NO, ET-1 and GLU plasma levels were determined at baseline, and at 8 h and 24 h after administration of somatostatin or octreotide via portal vein catheter in a randomized, double-blind, cross-over design. RESULTS: The average decrease in portal pressure after intravenous infusion of somatostatin and octreotide was 9.4 +/- 1.0 cmH2O and 5.0 +/- 1.0 cmH2O, respectively (P < 0.01). Plasma levels of GLU and IGF-1 decreased significantly 8 and 24 h after somatostatin and octreotide infusion (P < 0.05). However, there were no significant decreases in plasma NO or ET-1 levels. There was a significant difference between somatostatin and octreotide groups (P < 0.01). CONCLUSION: Both somatostatin and octreotide can significantly reduce portal pressure, although somatostatin is more potent than octreotide. The underlying mechanisms may involve inhibition of the secretion of GLU, IGF-1 and other hormones as well as a decrease in hepatic metabolism and portal inflow leading to a reduction in portal pressure.
Authors:
Jian-Fen Yang; Xing-Jiang Wu; Jie-Shou Li; Jien-Min Cao; Jian-Ming Han
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  17     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-13     Completed Date:  2005-04-12     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  53-7     Citation Subset:  IM    
Affiliation:
Research Institute of General Surgery, Jinling Hospital Nanjing 210002, Jiangsu Province, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Over Studies
Double-Blind Method
Female
Glucagon / blood
Humans
Hypertension, Portal / blood,  drug therapy*,  etiology,  physiopathology
Insulin-Like Growth Factor I / metabolism
Liver Cirrhosis / blood,  complications*,  physiopathology
Male
Middle Aged
Octreotide / therapeutic use*
Portal Pressure / drug effects
Somatostatin / therapeutic use*
Chemical
Reg. No./Substance:
51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I; 83150-76-9/Octreotide; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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