从指南共识发展看肢端肥大症规范化管理的必要性和重要性

The necessity and importance of standardized management of acromegaly:from the perspective of development of expert consensuses and clinical guidelines

肢端肥大症属于罕见病,其诊断、治疗和随访需要多学科团队协作完成。近年来,国内外肢端肥大症的临床研究取得了一系列成果,因此中国垂体腺瘤协作组召集国内神经外科、内分泌科、放射科和放疗科等相关领域的专家更新发布《中国肢端肥大症诊治共识(2021版)》,旨在进一步推动肢端肥大症的规范化和个体化管理。回溯过往,共识和指南确定并逐步修订形成广泛认可的生化缓解标准;药物治疗的选择和方案逐步被写入共识和指南,对规范化治疗具有重要指导意义;随着共识和指南中引入对并发症的关注,患者的远期生活质量日益受到重视。本文对国际上重要的肢端肥大症专家共识和临床指南进行简要回顾,从生化缓解标准、药物治疗以及合并症诊治三个方面探讨共识和指南对疾病规范化管理的重要推动作用。

Acromegaly is a rare disease,and multidisciplinary collaboration is essential for its diagnosis,treatment,and follow-up.In recent years,a series of novel findings have been echieved in clinical studies on acromegaly.Therefore,the China Pituitary Adenoma Specialist council has convened Chinese specialists in neurosurgery,endocrinology,radiology,and radiotherapy to release the Chinese Consensus for the Diagnosis and Treatment of Acromegaly(2021),which aims to promote the standardized and individualized management of acromegaly.Looking back to the past,the consensuses and guidelines have played vital roles in establishing the widely recognized biochemical remission criteria,promoting new drugs and novel therapeutic strategies which are of significance for standardized treatment,and emphasizing the need to focus on the systemic complications of acromegaly and the long-term quality of life.In this editorial,we briefly reviewed the expert consensuses and clinical guidelines on acromegaly at home and abroad,and discussed their important roles in promoting standardized disease management from three aspects including biochemical remission standards,medical treatment,and the diagnosis and treatment of systemic complications.