影响垂体促肾上腺皮质激素腺瘤经蝶手术后疗效的危险因素分析

目的研究可能影响垂体促肾上腺皮质激素（ACTH）腺瘤经蝶手术后疗效的危险因素。方法对1999年至2008年收治的垂体ACTH腺瘤经蝶手术的102例患者的临床资料进行回顾性研究。结果垂体ACTH腺瘤经蝶手术后疗效可能与肿瘤切除方式和肿瘤病理类型相关（P〈0.05）,而与肿瘤大小、术前24h尿游离激素水平无关（P〉0.05）。结论肿瘤的切除方式和肿瘤病理类型是影响垂体ACTH腺瘤经蝶手术后疗效的危险因素。

Risk factors related to curative effect of transsphenoidal surgery on ACTH-secreting pituitary adenomas

Objective To understand the risk factors related to the curative effect of transsphenodal surgery on the patients with ACTH-secreting pituitary adenomas.Method The clinical data of 102 patients with ACTH-secreting pituitary adenomas,who underwent transsphenodal surgery from 1999 to 2008,were analyzed retrospectively.Results The relief rate of the symptom （81.9%,68/83） was significantly higher in the patients with pituitary adenomas than that （57.9%,11/19） in the patients with pituitary hyperplasia or without histological abnormality in the pituitary body after the transsphenodal surgery （P 0.05）.The relief rate of the symptom （83.3%,60/72） was significantly higher in the patients with ACTH-secreting adenomas receiving the resection of the adenomas and a part of the peritumorous tissues than that （63.3%,19/30） in the patients with ACTH-secreting adenomas receiving selective resection of the adenomas （P0.05）.Conclusion The factors related to the prognosis in the patients with ACTH-secreting pituitary adenomas,which is not related to the volume of the adenomas and preoperative plasma cortisol level,include the pathological type of the tumors and the extend of resected tumors.Key Words ACTH-secreting pituitary adenomas;Transsphenoidal surgery;Risk factor;Prognosis