神经内镜经鼻蝶窦入路手术治疗垂体生长激素细胞腺瘤后生化缓解的影响因素分析  

Influencing factors of biochemical remission after endoscopic transsphenoidal surgery for growth hormone-secreting pituitary adenoma

作　　者：胡松佳 孙书光 林昌福 王东利 Hu Songjia;Sun Shuguang;Lin Changfu;Wang Dongli(Department of Neurosurgery,Henan Provincial Third People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院神经外科,郑州450000

出　　处：《中国实用医刊》2023年第2期68-71,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨垂体生长激素(GH)细胞腺瘤采取神经内镜经鼻蝶窦入路手术治疗后生化缓解的影响因素。方法抽取河南省直第三人民医院2016年3月至2022年2月收治的76例实施神经内镜经鼻蝶窦入路手术治疗的垂体GH细胞腺瘤患者纳入研究,术后观察患者生化缓解情况,分析生化缓解、生化未缓解患者的一般资料,采用Logistic回归方程分析神经内镜经鼻蝶窦入路手术治疗垂体GH细胞腺瘤后生化缓解的影响因素。结果76例垂体GH细胞腺瘤患者治疗后生化缓解45例(59.21%,45/76),生化未缓解31例(40.79%,31/76)。生化缓解与生化未缓解患者的GH水平、肿瘤最大径、肿瘤Knosp分级、肿瘤Hardy分期比较差异有统计学意义(P<0.05);生化缓解与生化未缓解患者性别、年龄、病程、胰岛素样生长因子-1水平、肿瘤Hardy分级比较差异未见统计学意义(P>0.05)。将上述有差异项目带入Logistic回归方程计算发现,GH水平、肿瘤最大径、肿瘤Knosp分级、肿瘤Hardy分期均是神经内镜经鼻蝶窦入路手术治疗垂体GH细胞腺瘤后生化缓解的影响因素(P均<0.05)。结论神经内镜经鼻蝶窦入路手术治疗的垂体GH细胞腺瘤患者仍存在生化未缓解现象,其中GH水平、肿瘤最大径、肿瘤Knosp分级、肿瘤Hardy分期是生化缓解的影响因素。临床应针对上述因素,采取相应的处理措施,以提升生化缓解率。Objective To investigate the influencing factors of biochemical remission of growth hormone(GH-secreting)pituitary adenoma after endoscopic transnasal transsphenoidal surgery.Methods Seventy-six patients with GH-secreting pituitary adenoma who underwent endoscopic transsphenoidal surgery in Henan Provincial Third People’s Hospital from March 2016 to February 2022 were included in the study.After surgery,the biochemical remission of patients was observed,and the general data of patients with biochemical remission and those without biochemical remission were analyzed.Logistic regression equation was used to analyze the influencing factors of biochemical remission after endoscopic transsphenoidal surgery for GH-secreting pituitary adenoma.Results Among the 76 patients with GH-secreting pituitary adenoma treated by endoscopic transsphenoidal surgery,45 patients(59.21%,45/76)had biochemical remission,and 31 patients(40.79%,31/76)had no biochemical remission.There were significant differences in GH level,major diameter of tumor,Knosp grade of tumor and Hardy stage of tumor between patients with biochemical remission and patients without biochemical remission(P<0.05).There was no significant difference in gender,age,course of disease,insulin-like growth factor 1 level and Hardy grade between patients with and without biochemical remission(P>0.05).Taking the above items with differences into the Logistic regression equation,it was found that GH level,major diameter of tumor,Knosp grade of tumor,and Hardy stage of tumor were the influencing factors of biochemical remission after endoscopic transsphenoidal surgery for GH-secreting pituitary adenoma(all P<0.05).Conclusions Patients with GH-secreting pituitary adenoma still may have no biochemical remission after endoscopic transsphenoidal surgery,moreover,GH level,major diameter of tumor,Knosp grade of tumor and Hardy stage of tumor are the influencing factors of biochemical remission.Clinical treatment measures should be taken according to the above factors to improve th

关 键 词：垂体生长激素 细胞腺瘤 神经内镜经鼻蝶窦入路手术 生化缓解 

分 类 号：R736.4[医药卫生—肿瘤]