垂体腺瘤伴肢端肥大症患者双侧颈内动脉间距变化病例对照研究

A case control study of distance change of bilateral internal carotid artery in acromegaly

目的讨肢端肥大症患者的双侧颈内动脉(internal carotid artery, ICA)间距的变化情况。方法纳入2016年8月至2018年3月期间福建医科大学附属第一医院神经外科确诊为垂体腺瘤伴肢端肥大症患者20例作为试验组,其中男7例,女13例,年龄21～62岁,并根据试验组性别、年龄选取同期的无功能型垂体腺瘤患者40例作为对照组,收集两组患者的临床特征,使用3D打印软件重建患者双侧ICA并测量ICA间距。结果相较于对照组患者而言,试验组患者的双侧ICA虹吸段膝状弯曲部的最大距离[(25.1±3.9)mm vs.(23.2±2.9)mm, P=0.041]和双侧ICA破裂孔段间距[(26.2±3.1)mm vs.(23.8±4.1)mm, P=0.022]均有明显扩大;双侧ICA海绵窦段间距[(20.7±4.3)mm vs.(22.4±3.1)mm, P=0.076]趋向于更小,但差异无统计学意义;双侧ICA眼段起始部间距无明显差异[(15.7±5.1)mm vs.(16.0±2.5)mm, P=0.783]。结论肢端肥大症患者的双侧ICA间距,较无功能型垂体腺瘤患者存在差异。双侧ICA虹吸段膝状弯曲部的最大距离和双侧ICA破裂孔段间距均有明显增大。

Objective To investigate the distance change of bilateral internal carotid artery in acromegalic patients.Methods Twenty patients with acromegaly were included in this study from August 2016 to March 2018 in Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University.There were 7 males and 13 females with an average age of 40.2±12.6 years(range from 21 to 62 years old).Forty sex and age matched patients with non-functional pituitary adenoma were selected as controls.The 3D printing software was used for reconstructing the internal carotid artery.Distances of the bilateral internal carotid arteries were measured on the reconstructed images.Results The maximum distance between bilateral siphon carotid ectasias(25.1±3.9 mm vs.23.2±2.9 mm,P=0.041)and distance between bilateral lacerum segments(26.2±3.1 mm vs.23.8±4.1 mm,P=0.022)were significantly longer in patients with acromegaly than in those without.Although the distance between bilateral cavernous segments(20.7±4.3 mm vs.22.4±3.1 mm,P=0.076)tended to be shorter,the difference was not statistically significant.The distance between bilateral ophthalmic segments was not significantly different between the two groups(15.7±5.1 mm vs.16.0±2.5 mm,P=0.783).Conclusion The distance of bilateral internal carotid artery of acromegalic patients is different from that of patients with non-functional pituitary adenomas.Patients with acromegaly have significantly longer distance between bilateral siphon carotid ectasias and distance between bilateral lacerum segments compared with the patients with non-functional pituitary adenomas.