【摘要】：目的:研究垂體生長激素腺瘤術(shù)后緩解與哪些因素有關(guān);探究影響和預(yù)測垂體生長激素腺瘤術(shù)后緩解的相關(guān)因素。方法:本研究回顧性分析2009年2月至2014年12月間在本中心接受同一手術(shù)小組實(shí)施經(jīng)蝶垂體生長激素腺瘤切除術(shù)的患者。根據(jù)術(shù)后緩解情況分為兩組,分別比較兩組間不同因素是否存在差異,應(yīng)用生存分析方法繪制生存曲線,判斷其是否影響術(shù)后緩解。并以Cox比例風(fēng)險(xiǎn)模型分別行單因素及多因素回歸,篩選預(yù)測和影響術(shù)后緩解的相關(guān)因素。結(jié)果:2009年2月至2014年12月在本中心接受經(jīng)蝶生長激素腺瘤切除術(shù)的患者共63例,3例因資料不完整予以排除。其中男性21人,女性39人,發(fā)病男女比例1:1.86。入選者平均年齡47.9±11.2歲,平均病程5.8±5.9年。中位隨訪時(shí)間440.5天。緩解36例,不緩解24例,總緩解率60%。緩解組與未緩解組年齡、性別無統(tǒng)計(jì)學(xué)差異;微腺瘤與大腺瘤、侵襲性腺瘤與非侵襲性腺瘤、術(shù)前GH30μg/L組與術(shù)前GH≤30μg/L組、術(shù)中GH下降率40%組與術(shù)中GH下降率≤40%組緩解率均有統(tǒng)計(jì)學(xué)差異。K-M生存曲線及Cox回歸分析結(jié)果提示腺瘤大小、腺瘤侵襲性、術(shù)前基礎(chǔ)GH水平是影響緩解的重要因素。術(shù)中生長激素下降率、術(shù)后早期GH水平是預(yù)測術(shù)后緩解的重要指標(biāo)。結(jié)論:術(shù)前高GH水平、大腺瘤、侵襲性腺瘤是垂體生長激素腺瘤術(shù)后緩解的不良因素。術(shù)中GH下降率40%對術(shù)后緩解具有一定的預(yù)測效果。術(shù)后第一日GH水平對于預(yù)測術(shù)后緩解具有良好的效果。
[Abstract]:Objective: to study the factors related to postoperative remission of pituitary growth hormone adenoma, and to explore the factors influencing and predicting postoperative remission of pituitary growth hormone adenoma. Methods: from February 2009 to December 2014, we retrospectively analyzed the patients undergoing transsphenoidal pituitary growth hormone adenectomy in our center. According to the condition of postoperative remission, we divided the two groups into two groups, and compared the difference of different factors between the two groups, and used the survival analysis method to draw the survival curve, and to judge whether the survival curve affected the postoperative remission. Univariate and multivariate regression were performed with Cox proportional risk model to screen the related factors to predict and influence postoperative remission. Results: from February 2009 to December 2014, 63 patients underwent transsphenoidal adenoma resection in our center. 3 patients were excluded because of incomplete data. Of these, 21 were male and 39 female, with a male to female ratio of 1: 1.86. The mean age was 47.9 鹵11.2 years and the mean course of disease was 5.8 鹵5.9 years. The median follow-up time was 440.5 days. There were 36 cases of remission and 24 cases of non-remission. The total remission rate was 60%. There was no significant difference in age and sex between remission group and non-remission group, microadenoma and macroadenoma, invasive adenoma and noninvasive adenoma, preoperative GH30 渭 g / L group and preoperative GH 鈮，

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