摘要
目的探讨肢端肥大症患者垂体瘤手术前后激素水平变化以及与预后的相关性。方法回顾性分析47例肢端肥大症患者在经鼻蝶入路垂体瘤切除术治疗的临床资料,并根据肿瘤大小将其分为微腺瘤组(直径<10 mm)和大腺瘤组(直径≥10 mm),动态观察两组患者手术前后血清生长激素(GH)、胰岛素样生长因子I(IGF-I)、泌乳素(PRL)水平的变化,并对患者随访分析手术前后激素水平与手术疗效的相关性。结果手术后两组患者血清GH、IGF-I水平均有明显下降;大腺瘤组术后PRL水平明显降低;手术后微腺瘤组IGF-I水平明显低于大腺瘤组,差异均有统计学意义(P<0.05)。手术总有效率为78.7%,术前GH水平是影响手术有效率的危险因素(OR=5.056,95%CI:0.896~28.534,P<0.05)。与手术无效组相比,手术有效组术后GH水平明显降低,差异有统计学意义(P<0.01)。结论手术切除垂体生长激素腺瘤可以有效降低肢端肥大症患者内分泌激素水平,监测患者手术前后内分泌激素水平的改变有助于了解患者的手术治疗效果。
Objective To identify the changes of endocrine hormone in patients with acromegaly before and after pituitary adenoma surgery and the correlation with prognosis. Methods The clinical data of 47 patients who underwent transsphenoidal microsurgery for acromegaly were retrospectively analyzed. According to the tumor size,the patients were divided into micro adenoma group（ 10 mm in diameter） and large adenoma group（ ≥10 mm in diameter）. Dynamically observe the change of serum growth hormone（ GH）,insulin-like growth factor I（ IGF-I） and prolactin（ PRL） before and after operation between the two groups. Evaluate the correlation of hormone levels before and after operation with the postoperative outcomes by follow-up analysis. Results The levels of serum GH and IGF-I were significantly lower in two groups; the serum PRL level was obviously reduced after operation in large adenoma group; compared with large adenoma group,the level of IGF-I in micro adenoma group was significantly reduced after operation（ P〈0. 05）. The total effective rate of surgery was 78. 7% and the preoperative GH level was a risk factor for it（ OR = 5. 056,95% CI = 0. 896-28. 534,P〈0. 05）. Compared with invalid surgery group,the level of GH in valid surgery group was significantly reduced after operation,with the differences statistically significant（ P〈0. 05）. Conclusion The level of endocrine hormone in patients with acromegaly were effectively reduced after pituitary adenoma surgery. Monitoring the changes of endocrine hormone in patients before and after operation was helpful to know the postoperative outcomes.
出处
《中国卫生检验杂志》
CAS
2017年第16期2284-2286,共3页
Chinese Journal of Health Laboratory Technology
基金
基金项目:首都临床特色应用研究( Z151100004015144)
