Zusammenfassung
Die Beeinflussung verschiedener Haemostaseparameter beim Menschen durch Kurzund Langzeit-Anwendung von Somatostatin (GIF) wurde untersucht. Das in der Studie eingesetzte Dosierungsschema bestand aus einer intravenösen Bolusinjektion von 250 µg GIF und einer anschließenden Dauerinfusion von 250 µg GIF/h. Bei 5 gesunden, freiwilligen Probanden war nach Beendigung einer Kurzzeittherapie über 3 h ein statistisch signifikanter Abfall der Thrombozytenzahl und eine Beeinträchtigung der Thrombozytenfunktion nachweisbar. Die Veränderungen lagen jedoch innerhalb des physiologischen Normalbereiches und waren innerhalb von 2 h nach Infusionsende voll reversibel. Andere Parameter (Blutungszeit, Thromboplastinzeit und Partialthromboplastinzeit, Fibrinogen, Fibrinogen/Fibrinspaltprodukte, Blutgerinnungsfaktor XIII, Äthanoltest) wurden nicht beeinflußt. Bei 2 Patienten mit Magenblutung bzw. persistierender Amylasämie wurde die Somatostatin-Behandlung über 67 bzw. 120 h durchgeführt. Ein klinisch relevanter Haemostasedefekt war bei Therapieende labordiagnostisch nicht erkennbar. Im Fall des Patienten mit Magenblutung kam es vielmehr 60 min nach Beginn der Therapie zum Sistieren der Haemorrhagie.
Die Untersuchungen haben gezeigt, daß nach Anwendung von Somatostatin beim Menschen unter Verwendung des angegebenen Dosierungsschemas weder klinische noch labordiagnostische Hinweise bestehen, die die Annahme einer klinisch relevanten, iatrogen-induzierten haemorrhagischen Diathese rechtfertigen.
Summary
The effect of short- and long-term somatostatin (GIF) administration on haemostatic function in man was investigated. The dosage programme applied in this study was 250 µg GIF as a bolus injection and 250 µg GIF/h by way of infusion. In five healthy volunteers a short-term (3 h) treatment resulted in a statistically significant drop of platelet count and impairment of platelet aggregation at the end of infusion. However, these changes were within the physiologically normal range and disappeared after two hours on all subjects. Other parameters such as bleeding time, thromboplastin and partial thromboplastin time, fibrinogen, fibrin/fibrinogen split products, plasma factor XIII, ethanol gelation test were not affected. In two patients with gastric haemorrhage and persistent amylasaemia a 67 or 120-h treatment induced no remarkable haemostatic defect. By contrast, peptic ulcer bleeding in one patient stopped 60 min after starting the GIF infusion.
These studies indicated that somatostatin administration in man at the dosage programme used neither results in clinical evidence indicating bleeding tendency nor does it influence laboratory parameters in an apparent way.
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Rasche, H., Raptis, S., Scheck, R. et al. Coagulation studies and platelet function after somatostatin infusion. Klin Wochenschr 54, 977–982 (1976). https://doi.org/10.1007/BF01468948
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DOI: https://doi.org/10.1007/BF01468948