title: Effect of somatostatin versus octreotide on portal haemodynamics in patients with cirrhosis and portal hypertension.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.affiliation: Research Institute of General Surgery, Jinling Hospital Nanjing 210002, Jiangsu Province, China.
authors.forename: Jian-Fen
authors.initials: JF
authors.lastname: Yang
authors.forename: Xing-Jiang
authors.initials: XJ
authors.lastname: Wu
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
authors.forename: Jien-Min
authors.initials: JM
authors.lastname: Cao
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Han
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D017082:Portal Pressure / Q000187:drug effects; D013004:Somatostatin / Q000627:therapeutic use*
chemical_list: D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D005934:Glucagon; D015282:Octreotide