垂体促甲状腺激素腺瘤的临床特征和术前短效奥曲肽治疗的临床疗效  

Clinical characteristics and outcomes of preoperactive short-acting octreotide treatment in patients with thyrotropin-secreting pituitary adenomas

作　　者：徐剑[1] 李征[1] 郭莹[1] 梁丹[1] 钟历勇[1] Xu Jian;Li Zheng;Guo Ying;Liang Dan;Zhong Liyong(Department of Endocrinology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院内分泌科,100070

出　　处：《中华内科杂志》2021年第4期345-349,共5页Chinese Journal of Internal Medicine

基　　金：首都医科大学基础临床科研合作基金 (16JL81)。

摘　　要：目的归纳分泌促甲状腺激素(TSH)垂体腺瘤(TSH腺瘤)的临床特征,评价术前短效奥曲肽治疗的临床疗效。方法回顾性分析首都医科大学附属北京天坛医院2008年1月至2018年1月明确诊断的垂体TSH腺瘤患者共40例。采集一般资料、实验室及影像学检查等临床资料;评价患者术前奥曲肽治疗的临床疗效。结果40例患者(男:女=24∶16),发病年龄(30.5±5.1)岁,大腺瘤35例(87.5%);最常见症状为甲状腺高代谢症候群,共32例(80.0%),其次是头疼、头晕,视力、视野受损和性腺功能减退。30例(75%)患者奥曲肽治疗3~5d甲状腺功能即恢复正常,总有效率90.0%;有效累计剂次超过10次的患者其治疗前游离甲状腺素(FT4)水平明显高于10次以下者。结论甲状腺高代谢症候群、垂体占位效应是垂体TSH腺瘤最常见的临床表现,术前奥曲肽治疗可有效控制甲状腺功能亢进,治疗前FT4水平是影响奥曲肽疗效的重要因素。Objective To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018.The general data,laboratory examinations and imaging findings were reviewed and analyzed.The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results The age of onset year of the 40 patients(male:female=24∶16)was(30.5±5.1)years.Among them,35 patients(87.5%)were with macroadenoma.The most common symptoms were thyroid hypermetabolism syndrome,followed by headache,dizziness,visual field damage and hypogonadism.The thyroid function of 30 patients(75%)recovered to normal within 3-5 days after the octreotide treatment.The total effective rate of the octreotide was 90.0%.The level of free thyroxine(FT4)before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses.Conclusions Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma.Preoperative octreotide treatment can effectively control hyperthyroidism.The level of FT4 is a crucial factor affecting the efficacy of octreotide.

关 键 词：分泌促甲状腺激素的脑垂体腺瘤 奥曲肽 治疗 

分 类 号：R736.4[医药卫生—肿瘤]