垂体GH腺瘤并发颅内动脉瘤的临床研究

Clinical research of pituitary growth hormone adenoma with intracranial aneurysm

目的探讨中国人中垂体GH腺瘤并发颅内动脉瘤的情况,分析影响颅内动脉瘤发生的临床危险因素。方法回顾性分析78例垂体GH腺瘤病人(垂体GH腺瘤组)及197例健康人群(对照组)的临床数据,均行头颈部CTA检查,比较两组颅内动脉瘤患病率,并将全部人群分为有动脉瘤组和无动脉瘤组,分析影响动脉瘤患病率的独立危险因素。结果垂体GH腺瘤组颅内动脉瘤的患病率为11.5%,对照组为3.0%,两组患病率具有统计学差异(P=0.005)。垂体GH腺瘤组女性颅内动脉瘤患病率为17.5%,明显高于对照组的2.5%(P=0.007),而两组男性颅内动脉瘤患病率没有统计学差异(P=0.634);在40～49岁、50～59岁这两个年龄段中,垂体GH腺瘤组与对照组颅内动脉瘤患病率均存在显著差异(P <0.05)。多因素Logistic回归发现:年龄(OR=1.112,95%CI:1.036-1.194,P=0.004)和垂体GH腺瘤(OR=3.762,95%CI:1.235-11.463,P=0.020)是影响动脉瘤患病率的独立危险因素。结论垂体GH腺瘤病人较正常人群颅内动脉瘤的患病率显著提高;且其患病率在女性及40～59岁病人中明显升高。在诊疗垂体GH腺瘤时应考虑合并颅内动脉瘤的可能。

Objective To explore the situation of pituitary growth hormone(GH) adenoma complicated by intracranial aneurysm(IA),and analyze the clinical risk factors influencing IA. Methods Clinical data of 78 patients with pituitary GH adenoma patients(pituitary GH adenoma group) and 197 healthy people(control group) were analyzed retrospectively. CTA examination was performed in all the patients, and the prevalence rate of IA was compared between the two groups. Then, all the patients were divided into IA group and non-IA group, and the independent risk factors influencing on IA prevalence rate were analyzed. Results The prevalence rate of IA was 11.5% in the pituitary GH adenoma group, and 3.0% in the control group. The difference in prevalence rate of IA between the two groups was statistically significant(P=0.005). The prevalence rate of IA in female patients with pituitary GH adenoma was 17.5%, significantly higher than 2.5% in the control group(P=0.007), while there was no statistical difference in males between the two groups(P=0.634). There were significant differences in the prevalence rate of IA in the patients aged 40 to 49 years old and 50 to 59 years old between the pituitary GH adenoma group and the control group(P<0.05). Multivariate logistic regression found that age(OR=1.112, 95%CI:1.036-1.194, P=0.004) and pituitary GH adenoma(OR=3.762, 95%CI:1.235-11.463, P=0.020) were the independent risk factors influencing the prevalence rate of IA. Conclusion The prevalence rate of IA in pituitary GH adenoma patients is significantly higher than that in the normal people, and is significantly higher in women and patients aged 40 to 59 years old. Therefore, the coexistence of IA should be considered in the diagnosis and treatment of pituitary GH adenoma.