垂体生长激素腺瘤病人术前应用奥曲肽的初步研究  

Primary study of preoperative treatment with octreotide for growth hormone-secreting pituitary adenoma

作　　者：毛志钢[1] 王海军[2] 朱永红[3] 何东升[2] 蓝海[2] 徐伟光[2] 冯雷[2] 

机构地区：[1]番禺区人民医院神经外科,广东广州511400 [2]中山大学附属第一医院神经外科,广东广州510080 [3]中山大学基础医学院组织胚胎学教研室,广东广州510080

出　　处：《中国微侵袭神经外科杂志》2006年第9期396-398,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的前瞻性探讨奥曲肽对生长激素腺瘤病人生长激素水平和瘤体中Ⅰ型、Ⅲ型胶原含量的影响。方法将25例病例随机分为治疗组13例和对照组12例。治疗组术前2周开始皮下注射奥曲肽,对照组直接手术。肿瘤标本行Ⅰ型、Ⅲ型胶原免疫组织化学染色,计算Ⅰ型、Ⅲ型胶原阳性面积百分比。比较两组手术前后生长激素水平、Ⅰ型、Ⅲ型胶原含量等。结果治疗组和对照组中,术后生长激素恢复正常的例数分别为9例和6例;治疗组与对照组Ⅰ型胶原阳性面积分别为(12.75±5.01)%和(36.86±11.27)%(P<0.05),Ⅲ型胶原阳性面积为(11.99±4.13)%和(13.12±5.13)%(P=0.40)。结论术前应用奥曲肽有助于降低生长激素腺瘤病人的生长激素水平,使瘤体中I型胶原含量减少,进而可能软化瘤体,为经蝶手术治疗创造有利条件。Objective To evaluate the influence of growth hormone level and contents of collagen types Ⅰ and Ⅲ in the adenoma tissue in the patients with growth hormone-secreting pituitary adenoma treated with octreotide preoperatively. Methods Twenty-five patients with solitary growth hormone-secreting pituitary adenomas were randomly classified therapy group （13 cases） and control group （12 cases）. Patients in the group therapy were subcutaneously injected with octreotide for 2 weeks before surgery. Immunohistochemistry, cryo-sections were immunostained for collagen types Ⅰ and Ⅲ, and the type Ⅰ, Ⅲ collagen positive area ratio was calculated. Pre-and post-operative serum growth hormone level, and contents of collagen types Ⅰ and Ⅲ were compared between two groups. Results Growth hormone level decreased to normal in 9 cases of group therapy, and in 6 of control group. The positive area of type I collagen in group therapy and control group was （12.75±5.01）% and （36.86±11.27）% respectively, P〈0.05. The positive area of type Ⅲ collagen was （11.99±4.13）% and （13.12±5.13）% respectively （P=0.40）. Conclusion Treatment with octreotide preoperatively could decrease the growth hormone level and content of type Ⅰ collagen in growth hormone adenomatous tissue, which may soften the adenomatous tissue, thus creating advantageous conditions for transsphenoidal surgery.

关 键 词：肢端肥大症 生长激素 胰岛素样生长因子Ⅰ 奥曲肽 胶原Ⅰ型 胶原Ⅲ型 垂体肿瘤 

分 类 号：R736.4[医药卫生—肿瘤]