生长激素瘤患者临床特征的回顾性分析

发布时间：2018-05-06 17:56

本文选题：生长激素瘤 + 临床症状　；参考：《解放军医学杂志》2017年07期

【摘要】：目的分析生长激素瘤(GH瘤)患者的临床特征,并总结其诊治经验。方法收集1990年1月-2016年12月在解放军总医院就诊的338例GH瘤患者的临床资料,回顾性分析其中病例资料较完整的252例患者的一般情况、病史资料、实验室及辅助检查结果、治疗方式及结果等,并对其中部分患者的疾病缓解情况进行随访。结果我院GH瘤患者收治数量逐年增加,近3年收治患者例数占总收治患者例数56.2%;GH瘤患者男女比例约为1:1,就诊年龄呈正态分布,41~50岁发病人数最多;GH瘤患者最常见的临床体征为手、足增大(60.7%),其次为鼻翼增大(35.7%),最常见的临床症状为头痛(42.5%),其次为视力、视野改变(26.6%);GH瘤患者最常见的临床并发症为糖代谢异常(72.6%),呼吸睡眠暂停、甲状腺肿或结节、心功能异常及结肠息肉发生率均明显上升(69.5%、56.4%、57.0%及54.1%),上述并发症检查患者例数分别占本研究总患者例数的42.1%、23.4%、37.3%、47.6%和14.7%;GH 23.37±1.42μg/L,IGF-1 804.28±273.93ng/ml;垂体GH瘤85.0%为大腺瘤;手术治疗仍为一线治疗方案,选择药物治疗患者较少;随访率38.0%(84/252),随访患者缓解率40.5%;术后早期GH水平判断手术长期缓解的阳性率与真实随访手术长期缓解的阳性率基本一致(χ2=3.368,P0.05)。结论近年收治GH瘤患者数量不断增加,临床常见体征和症状分别为肢端肥大和头痛;对本病并发症的筛查尚不系统,存在大量遗漏,仍须加强患者治疗后随访,以改善患者生存质量;术后早期GH水平测定对手术预后有较高预测价值。
[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.

【作者单位】：解放军总医院内分泌科;
【分类号】：R736.4

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