内分泌激素水平监测对生长激素型垂体腺瘤患者手术远期疗效的观察

目的 探讨内分泌激素水平监测对生长激素型垂体腺瘤患者手术远期疗效观察的意义.方法 动态观察2002至2009年在青岛大学医学院附属医院经显微外科手术治疗的38例生长激素型垂体腺瘤患者手术前后血清生长激素、泌乳素、甲状腺激素(T3、T4)、促甲状腺素(TSH)、血皮质醇(COR)和促肾上腺皮质激素(ACTH)的变化,并进行1年以上的随访和远期疗效评价.结果 生长激素垂体腺瘤全切患者22例,术后1周内生长激素水平明显下降[术后1周与术前分别为(2.49±0.22)μg/L和(9.24±0.56)μg/L,P＜0.05]且与以后的生长激素水平基本一致.术后1周内生长激素降至2.5μg/L以下者11例,11例生长激素未降至2.5μg/L以下,其中3例术后3年内复发.结论 术后1周的生长激素水平可作为判断手术疗效的指标之一,术后1周内生长激素降至2.5μg/L以下可作为判断临床治愈的指标.

Abstract：

Objective To investigate the effect of incretion hormones on growth pituitary adenoma ectomy patients and evaluate its long-term therapeutic efficacy. Methods A total of 38 growth pituitary adenoma patients were treated by adenoma ectomy between 2002 to 2009 at our hospital. The dynamic concentrations of serum prolactin (PRL), growth hormone (GH), cortisone, adrenocorticotrophic hormone (ACTH) and thyroid function (T3, T4 & thyroid-stimulating hormone) were monitored before and after microsurgery. All cases had been followed up for over one year to evaluate the long-term therapeutic efficacy.Results The level of GH decreased markedly within one week after ectomy [(2. 49 ± 0. 22 ) μg/L vs (9. 24 ±0. 56) μg/L,P ＜0. 05]and remained stable afterwards. Among 22 cases of GH-secreting pituitary adenoma with total removal, the post-operative level of GH dropped below 2. 5 μg/L in 11 cases but the other 11 cases did not. And 3 cases were recurrent within 3 years post-operation. Conclusions The GH level at Week 1 post-operation is one of the major indicators for evaluating the efficacy of surgery. And the level of GH dropping below 2. 5 μg/L at Week 1 post-operation may be used as a standard for clinical cure.

Effects of incretion hormones on growth pituitary adenoma ectomy and evaluation of long-term therapeutic efficacy

Objective To investigate the effect of incretion hormones on growth pituitary adenoma ectomy patients and evaluate its long-term therapeutic efficacy. Methods A total of 38 growth pituitary adenoma patients were treated by adenoma ectomy between 2002 to 2009 at our hospital. The dynamic concentrations of serum prolactin (PRL), growth hormone (GH), cortisone, adrenocorticotrophic hormone (ACTH) and thyroid function (T3, T4 & thyroid-stimulating hormone) were monitored before and after microsurgery. All cases had been followed up for over one year to evaluate the long-term therapeutic efficacy.Results The level of GH decreased markedly within one week after ectomy [(2. 49 ± 0. 22 ) μg/L vs (9. 24 ±0. 56) μg/L,P ＜0. 05]and remained stable afterwards. Among 22 cases of GH-secreting pituitary adenoma with total removal, the post-operative level of GH dropped below 2. 5 μg/L in 11 cases but the other 11 cases did not. And 3 cases were recurrent within 3 years post-operation. Conclusions The GH level at Week 1 post-operation is one of the major indicators for evaluating the efficacy of surgery. And the level of GH dropping below 2. 5 μg/L at Week 1 post-operation may be used as a standard for clinical cure.