發(fā)布時間：2018-05-06 17:56

  本文選題：生長激素瘤 + 臨床癥狀�。� 參考：《解放軍醫(yī)學雜志》2017年07期

【摘要】：目的分析生長激素瘤(GH瘤)患者的臨床特征,并總結其診治經驗。方法收集1990年1月-2016年12月在解放軍總醫(yī)院就診的338例GH瘤患者的臨床資料,回顧性分析其中病例資料較完整的252例患者的一般情況、病史資料、實驗室及輔助檢查結果、治療方式及結果等,并對其中部分患者的疾病緩解情況進行隨訪。結果我院GH瘤患者收治數量逐年增加,近3年收治患者例數占總收治患者例數56.2%;GH瘤患者男女比例約為1:1,就診年齡呈正態(tài)分布,41~50歲發(fā)病人數最多;GH瘤患者最常見的臨床體征為手、足增大(60.7%),其次為鼻翼增大(35.7%),最常見的臨床癥狀為頭痛(42.5%),其次為視力、視野改變(26.6%);GH瘤患者最常見的臨床并發(fā)癥為糖代謝異常(72.6%),呼吸睡眠暫停、甲狀腺腫或結節(jié)、心功能異常及結腸息肉發(fā)生率均明顯上升(69.5%、56.4%、57.0%及54.1%),上述并發(fā)癥檢查患者例數分別占本研究總患者例數的42.1%、23.4%、37.3%、47.6%和14.7%;GH 23.37±1.42μg/L,IGF-1 804.28±273.93ng/ml;垂體GH瘤85.0%為大腺瘤;手術治療仍為一線治療方案,選擇藥物治療患者較少;隨訪率38.0%(84/252),隨訪患者緩解率40.5%;術后早期GH水平判斷手術長期緩解的陽性率與真實隨訪手術長期緩解的陽性率基本一致(χ2=3.368,P0.05)。結論近年收治GH瘤患者數量不斷增加,臨床常見體征和癥狀分別為肢端肥大和頭痛;對本病并發(fā)癥的篩查尚不系統(tǒng),存在大量遺漏,仍須加強患者治療后隨訪,以改善患者生存質量;術后早期GH水平測定對手術預后有較高預測價值。
[Abstract]:Objective to analyze the clinical characteristics of the patients with growth hormone tumor (GH tumor) and to summarize the experience of diagnosis and treatment. Methods the clinical data of 338 patients with GH tumor in the General Hospital of PLA in December January 1990 were collected. The general situation, medical history data, laboratory and auxiliary examination results of 252 cases with complete cases were analyzed retrospectively. The treatment mode and results were followed up. Results the number of GH patients in our hospital increased year by year. The number of patients in our hospital was 56.2% in the last 3 years. The proportion of men and women in GH patients was about 1:1, the age was positive and the number of 41~50 years was the most; the most common GH tumor patients were. The clinical signs were hand, foot enlargement (60.7%), followed by increased nasal alar (35.7%), the most common clinical symptoms were headache (42.5%), followed by vision and visual field change (26.6%). The most common clinical complications of GH tumor patients were abnormal glucose metabolism (72.6%), respiratory sleep suspension, goiter or nodule, abnormal cardiac function and the incidence of colonic polyps. (69.5%, 56.4%, 57%, and 54.1%), the number of cases of these complications accounted for 42.1%, 23.4%, 37.3%, 47.6% and 14.7% of the total number of patients in the study, GH 23.37 + 1.42 g/L, IGF-1 804.28 + 273.93ng/ml, pituitary GH tumor 85% as large adenoma; surgical treatment was still a first-line treatment, fewer patients were selected, follow-up rate 38% (84/252), The remission rate of follow-up patients was 40.5%, and the positive rate of long-term remission in the early postoperative period of GH was consistent with the positive rate of long-term remission (x 2=3.368, P0.05). Conclusion the number of patients with GH tumor is increasing in recent years, and the common signs and symptoms are extremities hypertrophy and headache, and the screening of complications of this disease is not yet available. The system has a large number of omissions and still needs to be followed up after treatment to improve the patient's quality of life. Early postoperative GH levels have a high predictive value for the prognosis of the operation.

【作者單位】： 解放軍總醫(yī)院內分泌科;
【分類號】：R736.4

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