Hatrick A G, Boghalo P, Bingham J B, Ayres A B, Sonksen P H, Russell-Jones D L
Department of Medicine, United Medical and Dental School, St Thomas' Campus, London, UK.
Eur J Endocrinol. 2002 Jun;146(6):807-11. doi: 10.1530/eje.0.1460807.
Hypopituitary GH-deficient patients have an increased cardiovascular mortality and GH replacement in this population has resulted in considerable therapeutic benefit. GH replacement involves administration of a potentially mitogenic substance to patients with a previous or residual pituitary tumour. Our objective was to evaluate whether GH replacement results in an increase in the size of pituitary tumours.
This was a non-randomised observational study on patients recruited from the endocrine clinic. All subjects had GH deficiency, proven on an insulin tolerance test and were divided into those who were or were not receiving long-term GH replacement. Comparison of change in pituitary size was made with interval radiological imaging of the pituitary.
Seventy-five patients (40 men and 35 women) were in the study, 47 were on long-term GH replacement and there were 28 controls. The average length of treatment for the treated group was 3.6 patient years. Thirty-nine patients in the treated group had at least 2 years of GH treatment between imaging studies of the pituitary. Two patients in the treated group had an increase in pituitary size (non-functioning adenomas) and two in the control group (one functioning and one non-functioning adenoma adenoma). None of these four patients required further treatment. There was no statistically significant difference between the two groups.
Using a representative cohort of hypopituitary patients attending an endocrine clinic, GH replacement was not associated with an increased pituitary tumour recurrence rate. Although the results are not conclusive, in the period of observation GH had little adverse effect but longer studies are required to be certain.
垂体功能减退性生长激素缺乏患者的心血管死亡率增加，该人群的生长激素替代治疗已产生显著的治疗益处。生长激素替代治疗涉及向既往有垂体肿瘤或残留垂体肿瘤的患者施用一种具有潜在促有丝分裂作用的物质。我们的目的是评估生长激素替代治疗是否会导致垂体肿瘤体积增大。
这是一项对从内分泌诊所招募的患者进行的非随机观察性研究。所有受试者均经胰岛素耐量试验证实存在生长激素缺乏，并分为接受或未接受长期生长激素替代治疗的两组。通过垂体的间隔放射影像学检查比较垂体大小的变化。
75例患者（40例男性和35例女性）参与了本研究，47例接受长期生长激素替代治疗，28例为对照组。治疗组的平均治疗时长为3.6患者年。治疗组中有39例患者在垂体影像学检查期间接受了至少2年的生长激素治疗。治疗组中有2例患者的垂体体积增大（无功能性腺瘤），对照组中有2例（1例功能性腺瘤和1例无功能性腺瘤）。这4例患者均无需进一步治疗。两组之间无统计学显著差异。
在内分泌诊所就诊的垂体功能减退患者的代表性队列研究中，生长激素替代治疗与垂体肿瘤复发率增加无关。尽管结果尚无定论，但在观察期内生长激素几乎没有不良反应，但需要更长时间的研究来确定。
