垂体瘤术后成人生长激素缺乏症的临床研究

Clinical Analysis of Adult Growth Hormone Deficiency on the Postoperative Patients with Pituitary Adenoma

目的:了解垂体瘤术后患者的生长激素(GH)储备功能、成人生长激素缺乏症(AGHD)的发生情况及其相关因素。方法:对垂体瘤手术后的患者进行胰岛素低血糖兴奋试验(ITT)分析GH分泌功能。结果:共入组17例患者,其中男性11例,女性6例;年龄中位数为47岁;其中仅2例兴奋后GH分泌正常,15例为严重的AGHD,且合并1种或1种以上垂体激素的缺乏。11例同时行胰岛素样生长因子1(IGF-1)水平测定,其中9例正常,2例下降;2例IGF-1低下的患者经ITT兴奋后GH分泌缺乏,且为严重AGHD;9例IGF-1水平正常的患者中,2例经ITT兴奋后GH分泌正常,余7例都为严重AGHD。结论:在垂体瘤术后的患者中,AGHD的发生率高;存在有1种或1种以上垂体激素缺乏的患者基本上都合并AGHD;IGF-1不能用于AGHD的诊断。

Objective：To study the reserve function of growth hormone（GH）,the incidence rate of adult growth hormone deficiency（AGHD） and its correlation factors in the postoperative patients with pituitary adenoma.Methods：The insulin tolerance test（ITT） was performed in the postoperative patients with pituitary adenoma.Results：ITT was performed in 17 patients（11 male,6 female）.The median age was 47.Only two patients had normal GH response,with fifteen severe deficient together with one or more than one kind of pituitary hormone deficiency.Among 17 cases,11 cases were determined insulin-like growth factor-1（IGF-1） meanwhile（9 normal,2 decreased）.Two cases with low IGF-1 level were confirmed as serious AGHD by ITT.Among the nine cases with normal IGF-1 level,two were confirmed normal by ITT,and the others as AGHD.Conclusions：There is a high incidence rate of AGHD in the postoperative patients with pituitary adenoma.AGHD often occurs in the patients with one or more than one kind of pituitary hormone deficiency.IGF-1 can not be used as a diagnose method of AGHD.