肢端肥大症的死亡风险及影响因素

Mortality in acromegaly

肢端肥大症(acromegaly)是一种起病隐匿的慢性进展性内分泌代谢性疾病, 可引起多系统并发症。肢端肥大症患者的死亡风险较一般人群增加2~3倍, 既往传统的手术治疗并不能使死亡风险回归正常, 术后仍有40%~50%的患者血清生长激素水平未缓解, 这和患者死亡率增加密切相关。随着治疗药物的增多, 已证明长效生长抑素受体配体(somatostatin receptor ligands, SRLs)、生长激素受体拮抗剂(GH receptor antagonist, GHRA)等药物可有效控制患者生长激素水平, 进一步降低患者的死亡风险。本文对肢端肥大症患者的死亡风险及不同治疗方式对死亡风险的影响进行综述。

Acromegaly is a chronic disorder characterized by growth hormone(GH)hypersecretion,which could cause multiple systemic complications.Patients with acromegaly are associated with an increased risk of death in the general population.Traditional surgical treatment does not normalize the risk of death,and serum GH levels remain unrelieved in about 40%-50%patients after surgery,which is closely related to the increased mortality.As the increase of therapeutic drugs,somatostatin receptor ligands(SRLs),GH receptor antagonist(GHRA)and other drugs have been proved to be effective in controlling the level of GH in patients,and further reduce the risk of death.This review focuses on treatment and mortality in acromegaly.