肢端肥大症患者79例临床治疗分析  

Clinical analysis of treatment of 79 cases with acromegaly

作　　者：潘绵顺[1] 孙海辉[1] 王鹏[1] 汪业汉[2] 郭裕天[1] 黄润生[3] 

机构地区：[1]武警上海总队医院伽玛刀中心,上海201103 [2]安徽省立医院神经外科,安徽合肥230001 [3]解放军第117医院伽玛刀中心,浙江杭州310021

出　　处：《中华神经外科疾病研究杂志》2009年第2期157-160,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：卫生部科研基金资助项目(WKJ2005-3-006)

摘　　要：目的探讨使用长效生长抑素类似物结合神经外科切除或伽玛刀治疗后激素变化和影像学复查来评价肢端肥大症患者治疗疗效。方法肢端肥大症患者79例,其中男性51例,女性28例,分为长效生长抑素(兰瑞肽lanreotideTM)结合神经外科切除治疗(A组)和长效生长抑素(兰瑞肽lanreotideTM)结合伽玛刀治疗组(B组),所有患者均给予肌注长效生长抑素,在药物使用结束4w后对患者进行临床评估并施行经蝶窦手术切除肿瘤或者接受伽玛刀治疗。随访瘤体体积变化及内分泌水平变化。结果多数患者的临床症状得到显著改善。与垂体微腺瘤组相比,药物治疗对垂体大腺瘤组体积缩小有更明显的作用。手术组微腺瘤组明显优于大腺瘤组;放射外科组结果:肿瘤缩小概率随随访时间的延长会明显提高,而且随着随访时间的延长,生长激素(GH)和胰岛素生长因子(IGF-I)值降至正常的概率明显提高。结论生长抑素类似物(兰瑞肽lanreotideTM)结合神经外科切除或伽玛刀治疗肢端肥大症患者可以获得较好的临床疗效,远期疗效有待于进一步观察。Objective To investigate the therapeutic effect of lanreotide^TM plus neurosurgical resection or gamma knife on acromegaly by detecting the hormone and tumour volume. Methods A total of 79 patients were included in the study. They were divided into lanreotide^TM plus neurosurgery group （n =21 ） and lanreotide^TM plus gamma knife radiosurgey group. All the patients were given a dose of 30 mg lanreotide^TM for 8 to 10 weeks and were evaluated their improvements of clinical symptoms . And then they received neurosurgery or gamma knife radiosurgery. Hormone and tumour volume changes were followed-up. Results Clinical symptoms of most patients were improved. The data demonstrated that lanreotide^TM was more effective in decreasing the growth hormone （GH） level of microadenomas than that of macroadenomas. Lanreotide^TM was also more effective in decreasing the tumor volumes. The results showed that neurosurgery was more effective for microadenoma than macroadenoma. In the radiosurgery group, decrease of tumour volume was more obvious and more patients could achieve the normal endocriological level as the follow-up increased. Conclusion Lanreotide^TM plus neurosurgery or gamma knife radiosurgery is effective in treatment of acromegaly.

关 键 词：伽玛刀 兰瑞肽 肢端肥大 

分 类 号：R730.55[医药卫生—肿瘤]