奥曲肽抑制试验在肢端肥大症中的特征研究及应用  

Characteristics and application of octreotide suppression test in acromegaly

作　　者：刘建青 吴可炀 郭伟红[1] 何庆[1] LIU Jianqing;WU Keyang;GUO Weihong;HE Qing(Department of Endocrinology and Metabolism,General Hospital,Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院内分泌代谢科,天津300052

出　　处：《天津医科大学学报》2024年第3期250-254,共5页Journal of Tianjin Medical University

基　　金：天津市科技人才培育项目(RC20126)。

摘　　要：目的:探讨奥曲肽抑制试验(OST)在肢端肥大症中的特征及其对疾病诊治的应用价值。方法:选取2019年12月—2022年12月在天津医科大学总医院内分泌代谢科治疗的28例肢端肥大症患者(其中20例患者已行外科手术且术后病理报告为垂体生长激素瘤)行OST,计算0.5、1、1.5、2、4、6、8、10、12、16和24 h各时间点的生长激素(GH)抑制率,对6例应用生长抑素类似物(SSA)治疗的患者进行随访,分析患者在接受长效SSA治疗前后的GH、胰岛素样生长因子-1(IGF-1)水平的下降情况,并评估OST在肢端肥大症患者接受长效SSA治疗的预测效果。结果:肢端肥大症患者在实验室生化检查时的GH、IGF-1水平均高于正常范围,行OST期间除了5例患者GH最高抑制率小于50%,其余患者均大于50%,且有12例患者抑制率大于75%。GH抑制率达到最高点时所需平均时间为(3.1±1.0)h,与患者基础GH水平不存在明显相关性(r=-0.196,P=0.467),同时抑制率达到最高点时的GH水平与患者基础GH水平无明显相关性(r=-0.187,P=0.488)。接受醋酸奥曲肽微球治疗患者的GH、IGF-1水平均有显著下降,降低率分别为(58.58±15.20)%、(35.79±15.69)%,行OST期间患者GH最高抑制率与接受醋酸奥曲肽微球治疗患者GH抑制率不存在显著性差异(z=-1.32,P=0.207)。结论:OST具有创伤小、不良反应发生率低、操作安全性高、相对经济有效的特征,可指导肢端肥大症患者后续药物治疗,在肢端肥大症的诊疗中有重要参考价值。Objective:To explore the characteristics of octreotide suppression test(OST)in acromegaly and its application value in disease diagnosis and treatment.Methods:A total of 28 patients with acromegaly admitted to the Department of Endocrinology and Metabolism,Tianjin Medical University General Hospital from December 2019 to December 2022(including 20 patients who underwent surgical treatment and had postoperative pathological reports of pituitary growth hormone tumors)were selected for the octreotide suppression test.The growth hormone(GH)suppression rate at different time points of 0.5,1,1.5,2,4,6,8,10,12,16,and 24 hours were calculated.Follow-up was conducted on 6 patients treated with somatostatin analogs(SSA)to analyze the decrease in GH and insulin-like growth factor-1(IGF-1)levels before and after receiving SSA treatment,and to evaluate the predictive effect of OST on SSA treatment in patients with acromegaly.Results:The levels of GH and IGF-1 in patients with acromegaly during laboratory biochemical tests were all higher than the normal range.During OST,except for 5 patients,the highest GH suppression rate was less than 50%,and all other patients were greater than 50%,with 12 patients having suppression rates greater than 75%.The average time required for GH suppression rate to reach its highest point was(3.1±1.0)hours,and there was no significant correlation with the patients′baseline GH level(r=-0.196,P=0.467).At the same time,the GH level with the highest suppression rate was not significantly correlated with the patients′baseline GH level(r=-0.187,P=0.488).The levels of GH and IGF-1 in patients receiving treatment with octreotide acetate microspheres significantly decreased,with reduction rates of(58.58±15.20)%and(35.79±15.69)%,respectively.There was no significant difference in the highest GH suppression rates between patients undergoing OST and those receiving treatment with octreotide acetate microspheres(z=-1.32,P=0.207).Conclusion:OST has the characteristics of minimal trauma,low incidence of

关 键 词：奥曲肽抑制试验 肢端肥大症 生长激素 

分 类 号：R58[医药卫生—内分泌]