94例肢端肥大症住院患者的临床病理及疗效分析

发布时间：2018-04-09 17:35

本文选题：肢端肥大症　切入点：生长激素　出处：《中国现代医学杂志》2017年26期

【摘要】：目的整理94例肢端肥大症住院患者的临床资料,探讨诊断准确性与疗效,阐明其临床特征。方法采用回顾性研究,应用SPSS 22.0统计软件进行分析。结果 94例患者中,男性31例(33.0%)、女性63例(67.0%),就诊年龄14~72岁,以41~50岁比例最大(35.1%)。首发症状中,容貌改变或手足改变78例(83.0%),头痛43例(45.7%),视力下降或视野缺损41例(43.6%),闭经或泌乳11例(11.7%),不育或性功能障碍2例(2.1%)。影像学检查,CT检出10例(10.6%),MRI检出84例(89.4%),明确描述肿瘤大小66例,大腺瘤及巨大腺瘤占93.94%,微腺瘤仅为6.06%。血清生长激素(GH)水平与肿瘤大小呈正相关(P0.05)。93例行手术治疗,除微腺瘤外,术后血清GH水平较术前下降。行手术治疗同时完善免疫组织化学检查共90例,GH表达阳性占94.45%;ROC曲线显示,术前血清GH水平与术后免疫组织化学GH表达情况无关。结论 94例患者,女性多于男性,就诊年龄主要集中于31~60岁,首发症状以容貌改变或手足改变、头痛、视力下降或视野缺损多见,大腺瘤及巨大腺瘤居多。GH水平与肿瘤大小呈正相关,且手术治疗可使GH水平降低。免疫组织化学GH表达情况与术前血清GH水平不完全符合,GH水平对免疫组织化学GH表达阳性患者的诊断准确性较低。
[Abstract]:Objective to analyze the clinical data of 94 patients with acromegaly, to explore the diagnostic accuracy and curative effect, and to elucidate its clinical features.Methods retrospective study and SPSS 22. 0 statistical software were used to analyze.Results among the 94 patients, 31 cases were male (33. 0%) and 63 cases were female (67.0%). The age of seeing a doctor was 14 ~ 72 years old, and the proportion of 41 to 50 years old was the highest (35. 1%).The serum GH level was positively correlated with the tumor size (P 0.05). 93 cases were treated surgically. The serum GH level was lower than that before operation except for microadenoma.At the same time, 90 cases had positive expression of GH in 94. 45% and ROC curve showed that there was no correlation between preoperative serum GH level and postoperative immunohistochemical expression of GH.Conclusion 94 patients, female is more than male, the age of visit is mainly 31to 60 years old, the first symptom is appearance change or hand and foot change, headache, visual acuity decline or visual field defect are more common.The level of GH was positively correlated with the size of tumor, and the level of GH decreased after surgical treatment.The expression of GH by immunohistochemistry was not consistent with the serum GH level before operation, and the diagnostic accuracy of GH expression was lower in patients with positive expression of GH by immunohistochemistry.
【作者单位】：中国医科大学附属第一医院内分泌与代谢病科(内分泌研究所与辽宁省内分泌疾病重点实验室);
【基金】：辽宁省科技厅计划(No:2012225021)
【分类号】：R584.11

【相似文献】