摘要
目的探讨生长激素(GH)测定在垂体GH腺瘤手术预后或远期结果判断中的意义。方法回顾性分析42例垂体GH腺瘤病人的经蝶手术结果。在术前、术后1d及1周空腹检测垂体各轴激素;2005年起,监测26例经蝶手术中不同阶段GH情况。结果本组总缓解率为54.8%(23例),侵袭性与非侵袭性腺瘤术后缓解率有统计学差异(P=0.008)。术前GH>30μg/L组与GH≤30μg/L组、术中GH下降大于50%组与GH下降不足30%组、术后早期与术后远期(半年以上)、术后口服糖耐量试验后GH水平(GH/OGTT)≤2.5μg/L组与GH/OGTT>2.5μg/L组术后缓解率均具有统计学差异(P<0.05)。结论术前、术后早期(术后10d以内)GH水平和术中GH监测对判断垂体GH腺瘤手术预后有高度预测价值。在判断术后缓解方面,GH/OGTT比空腹GH更具价值。
Objective To evaluate significance of GH in assessment of surgical prognosis and long term outcome after surgery for GH-secreting pituitary adenoma. Methods The outcomes of transsphenoidal surgery were analyzed retrospectively in 42 patients with GH-secreting pituitary adenoma. The level of each pituitary axis hormone in fasting blood samples was measured before and 1 day and 1 week after the operation. In addition, intra-operative GH measurements were performed at two or three periods of transsphenoidal pituitary surgery in 26 patients since 2005. Results Total remission rate was 54.8% （n=23） and its statistical difference was found between invasive adenoma and noninvasive adenoma （P=0.008）. The statistical difference in remission rate was also observed between the preoperative GH〉30μg/L group and GH ≤ 30μg/L group, intra-operative GH level reduction 〉 50% group and 〈 30% group, early postoperative period and long-term postoperative period （more than 0.5 year）, GH level after oral glucose tolerance test （GH/OGTT） ≤ 2.5μg/L group and GH/OGTT〉2.51μg/L group （P〈0.05 in all）. Conclusions Preoperative and early postoperative GH levels （within 10 d after surgery）, and intra-operative GH measurements may predict clinical outcome in post-surgical management of GH-secreting pituitary adenoma patients. GH/OGTT level is more significant than fasting GH level in the determination of postoperative remission status.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2009年第4期152-155,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
上海自然科学基金资助(编号:08ZR1413800)
关键词
垂体肿瘤
生长激素
预后
神经外科手术
pituitary neoplasms
growth hormone
prognosis
neurosurgical procedures
