解放军医学杂志2017，Vol.42Issue(7)：597-602,6.DOI:10.11855/j.issn.0577-7402.2017.07.04
生长激素瘤患者临床特征的回顾性分析
A retrospective study on the clinical characteristics of patients with growth-hormone adenoma
彭璐 1杨国庆 1巴建明 1吕朝晖 1陆菊明 1母义明 1窦京涛 1李乐乐 1臧丽 1金楠 1裴育 1谷伟军 1杜锦 1王先令1
作者信息
- 1. 100853 北京 解放军总医院内分泌科
- 折叠
摘要
Abstract
Objective To evaluate the clinical characteristics of patients with growth-hormone adenoma (GHA) and summarize the diagnosis and treatment experience.Methods The clinical data of 338 GHA cases at the General Hospital of PLA from Jan. 1990 to Dec. 2016 were collected, of which 252 cases with more complete clinical data were retrospectively analyzed including their general situation, medical history, laboratory tests and auxiliary examinations, and treatment modalities and outcomes. Parts of the patients were followed up.Results The cases of hospitalized GHA patients have increased year by year since 1990, and the number of patients admitted in the last 3 years accounted for 56.2% of the total number of cases. The sex ratio for GHA patients was nearly 1:1. Age of visiting followed Gaussian distribution while the 41-50 age group occupied the largest part. The most typical sign is hand and foot enlargement (60.7%), followed by the hypertrophy of nasal ala. The most common symptoms are headache (42.5%), hypopsia, visual field defect and diplopia. More than half of GHA patients were complicated with prediabetes and diabetes (72.6%), sleep apnea (69.5%), goiter or thyroid nodularity (56.4%), cardiac insufficiency (57.0%) and colon polyp (54.1%); while the percentages of cases undergone the relevant examination in the total number of cases were as follows: 75g OGTT test (42.1%), polysomnography (23.4%), thyroid ultrasound (37.3%), echocardiogram (47.6%) and colonoscopy (14.7%); GHA was 23.37±1.42μg/L and IGF-1 was 804.28±273.93ng/ml on average; 85.0% of somatotroph tumors are macroadenoma. Surgery remains the mainstay of therapy to GHA, while medical therapy was selected by less patients. During the follow-up, only 38.0%of GHA patients can be contacted, among them the remission rate decreased to 40.5%. The positive rate of long-term remission evaluated by early postoperative GHA level was consistent with that confirmed by the long-term follow-up (χ2=3.368,P>0.05). Conclusions The number of hospitalized GHA patients have increased recent years. The common clinical signs and symptoms are somatic enlargement and nonspecific headache. Due to uncompleted screening, GHA associated complications are always misdiagnosed; It is essential to establish a sound model of follow-up to improve patients' quality of life. The early postoperative GHA levels may predict the prognosis of surgery.关键词
生长激素瘤/临床症状/生长激素/手术治疗/缓解Key words
growth-hormone adenoma/clinical symptom/growth hormone/surgical treatment/remission分类
医药卫生引用本文复制引用
彭璐,杨国庆,巴建明,吕朝晖,陆菊明,母义明,窦京涛,李乐乐,臧丽,金楠,裴育,谷伟军,杜锦,王先令..生长激素瘤患者临床特征的回顾性分析[J].解放军医学杂志,2017,42(7):597-602,6.
