487例垂体腺瘤伽玛刀治疗后内分泌学远期效果分析  

The analysis of long-term effect on endocrine of 487 pituitary adenomas treated with gamma knife

作　　者：高寒[1] 徐波涛[1] 梁军潮[1] 王伟民[1] 吴鸿勋[1] 周丽兰[1] 宁琼芳[1] 

机构地区：[1]广州军区广州总医院神经外科,广州510010

出　　处：《立体定向和功能性神经外科杂志》2007年第1期25-27,47,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的评估487例垂体腺瘤行伽玛刀治疗后内分泌方面的改变,并分析性功能的改善情况。方法对487例垂体腺瘤患者进行立体定向伽玛刀治疗,对他们作半年到7年的随访,记录其血液内分泌的水平和性功能的状况并进行了分析。结果在随访的患者中,PRL腺瘤和GH腺瘤内分泌水平分别有53.7%、31.8%降至正常,而分别有24.2%、45.5%继续升高;在PRL腺瘤伽玛刀术后内分泌水平继续升高的患者中,有较高比例是术后自行停止服用溴隐亭;无功能型、PRL型、GH型、混合型垂体腺瘤性功能明显改善分别为1.7%、28.8%、10.8%、20.0%。结论立体定向伽玛刀放射外科治疗垂体腺瘤可以改善内分泌学方面的异常,单从这一角度分析该方法可以作为垂体腺瘤的首选治疗,并完全替代传统的分次放疗。伽玛刀治疗后仍然需要继续服用溴隐亭。伽玛刀治疗可以改善垂体腺瘤患者的性功能;但为了更好的改善性功能,提倡对垂体腺瘤(包括垂体微腺瘤)进行早期的立体定向伽玛刀治疗。Objective To evaluate the changes of endocrine in 487 patients with pituitary adenomas treated by gamma knife and analyze the improvement of sexual function. Methods 487 cases of pituitary adenomas were performed with stereotactic gamma knife,and followed up for 6 months to 7 years. The endocrine level in serum and sexual function were recorded, and their changes were analyzed. Results In the patients followed up, the blood endocrine level decreased to normal was achieved in 53. 7% and 31.8% of PRL and GH pituitary adenomas respectively, and the percentage of increase continually was 24. 2% and 45. 5% respectively. In the group of PRL pituitary adenomas with endocrine level still going up after treatment with gamma knife, there was a higher percentage of patients who stopped taking bromocriptine without the doctor＇s advice. The significant improvement of sexual function in nonfunctional, PRL, GH and mixed type was achieved 1.7%, 28. 8%, 10. 8% and 20. 0%,respectively. Conclusion The treatment using stereotactic gamma knife radiosurgery on pituitary adenomas could achieve improvement of endocrine level,and in terms of this point of view, the treatment could be the first choice of pituitary adenomas,and replace conventional radiotherapy completely. Bromocriptine should be taken continually after the gamma knife treatment. The treatment of gamma knife could also improve sexual function of patients with pituitary adenomas, and we recommend that the treatment of stereotactic gamma knife should be performed early on pituitary adenomas, including microadenomas, in order to achieve a better effect on sexual function.

关 键 词：伽玛刀 垂体腺瘤 内分泌 性功能 

分 类 号：R730.55[医药卫生—肿瘤] R736.4[医药卫生—临床医学]