垂体性库欣病手术疗效分析  

Transsphenoidal surgery on pituitary Cushing's disease: efficiency evaluation

作　　者：何新尧[1] 陈晓[1] 施秀华[2] 卞留贯[1] 孙青芳[1] 王卫庆[3] 宁光[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经外科,上海200025 [2]皖南医学院附属芜湖市第二人民医院肿瘤科,安徽芜湖241000 [3]上海交通大学医学院附属瑞金医院内分泌代谢科,上海200025

出　　处：《中华神经外科疾病研究杂志》2013年第6期535-539,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81270856)

摘　　要：目的分析垂体性库欣病经蝶垂体促肾上腺皮质激素腺瘤切除术疗效。方法对2009年1月至2012年11月我科收治的122例库欣病经蝶垂体腺瘤切除术的患者进行回顾性研究。统计分析术后相关激素下降水平,判定库欣病经蝶垂体腺瘤切除术疗效。结果 122例库欣病经蝶手术的患者,经过统计分析,其中111例缓解,11例不缓解,缓解组与未缓解组的术后血皮质醇水平差异在各时间段均有统计学意义(P<0.05),术后24 h尿皮质醇水平差异在术后1～2 d和术后3～6个月有统计学意义(P<0.05)。结论经蝶垂体腺瘤切除术是目前治疗库欣病的有效首选方法。术后血清皮质醇水平、24 h尿皮质醇水平以及血浆促肾上腺皮质激素水平是库欣病患者经蝶垂体促肾上腺皮质激素腺瘤切除术后疗效评估的最有效指标。Objective To investigate the effect of transsphenoidal surgery for the Cushing＇s disease. Methods A total of 122 patients with Cushing＇s disease admitted in our department from January 2009 to November 2012 were analyzed retrospectively. Pre-operative and post-operative hormonal levels were tested. Results The remission rate was 90.9%. There is a significant difference between remission group and non- remission group in the plasma cortisol levels at different time points post-operatively. （ P 〈 0.05 ）, however, 24 h urinary free cortisol level just at the time of 1 to 2 d and 3 - 6 months post-operation showed significant differences （ P 〈 0. 05 ）. Conclusion Transsphenoidal surgery is an effective method for the treatment of Cushing＇s disease. After transsphenoidal surgery, the prognosis can be judged by post-operative plasma cortisol level, 24 h urinary free cortisol level and adrenocoticotropic hormone level.

关 键 词：库欣病 血清皮质醇 24h尿皮质醇 血浆促肾上腺皮质激素 经蝶手术 

分 类 号：R736.4[医药卫生—肿瘤]