Schäffler A
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg, Regensburg.
Internist (Berl). 2006 Dec;47(12):1215-6, 1218-20, 1222. doi: 10.1007/s00108-006-1727-3.
Evidence based drug therapy is currently available for the treatment of prolactinomas and growth hormone secreting adenomas (acromegaly). Dopamine agonists such as bromocriptine, quinagolide or cabergoline represent the standard therapy for the treatment of micro- and macro-prolaktinomas. In pregnancy, more differentiated, individual and patient-adapted therapeutic procedures have to be considered. Transsphenoidal adenomectomy is the treatment of choice for patients suffering from acromegaly. If biochemical cure (defined by normalized IGF-1 serum levels or by a GH nadir <1 microg/l during a 3-h oral glucose tolerance test) cannot be achieved, somatostatin analogues such as octreotide and lanreotide are effective. In some cases, dopamine agonists can be added. In therapy-resistant cases, growth hormone receptor antagonists can be used.
目前有基于证据的药物疗法可用于治疗催乳素瘤和生长激素分泌腺瘤（肢端肥大症）。多巴胺激动剂如溴隐亭、喹高利特或卡麦角林是治疗微催乳素瘤和大催乳素瘤的标准疗法。在孕期，必须考虑更具针对性、个体化且适合患者的治疗方法。经蝶窦腺瘤切除术是肢端肥大症患者的首选治疗方法。如果无法实现生化治愈（定义为口服葡萄糖耐量试验期间IGF-1血清水平正常化或生长激素最低点<1微克/升），则生长抑素类似物如奥曲肽和兰瑞肽是有效的。在某些情况下，可以加用多巴胺激动剂。在治疗抵抗的病例中，可以使用生长激素受体拮抗剂。
