Bolanowski Marek, Zatonska Katarzyna, Kaluzny Marcin, Zielinski Grzegorz, Bednarek-Tupikowska Grazyna, Bohdanowicz-Pawlak Anna, Daroszewski Jacek, Szymczak Jadwiga, Podgorski Jan Krzysztof
Department of Endocrinology, Diabetology and Isotope Therapy, Medical University Wrocław, and Department of Neurosurgery, Central Military Hospital, Poland.
Neuro Endocrinol Lett. 2006 Dec;27(6):828-32.
Acromegaly is a rare disease with increased mortality rate. The aim was to present our centre experience in the diagnosis and treatment of a series of patients suffering from acromegaly.
130 patients (55 men, 75 women) aged 19-84 years presenting with clinical and hormonal features of acromegaly, attending Department of Endocrinology and Out-patient Clinic between 1990 and 2004 were studied. They were analyzed their GH and IGF-1 levels, CT and MRI scans, and they were administered medical therapy, neurosurgery and radiotherapy.
We have observed 106 macro-, 16 microadenomas and 1 case of ectopic GHRH. 115 patients were operated, as cured were recognized 74 of them. Pituitary irradiation was applied to 11 patients, in 4 of them it did not cure the disease. Medical therapy was efficacious in 12% patients treated with bromocriptine, 73% with long-acting lanreotide and 58% with long-acting octreotide. In 7 patients other malignant neoplasm were detected. 11 patients died during the follow-up.
There is possible underdiagnosis of acromegaly in our region, especially in males. We have observed better diagnostic opportunities in recent years when MRI was available. It was accompanied by better outcome of surgical and pharmacological treatment and better control of the complications of the disease.
肢端肥大症是一种死亡率增加的罕见疾病。目的是介绍我们中心对一系列肢端肥大症患者的诊断和治疗经验。
研究了1990年至2004年间到内分泌科和门诊就诊的130例年龄在19 - 84岁之间、具有肢端肥大症临床和激素特征的患者(55名男性,75名女性)。分析了他们的生长激素(GH)和胰岛素样生长因子-1(IGF-1)水平、CT和MRI扫描结果,并给予他们药物治疗、神经外科手术和放射治疗。
我们观察到106例大腺瘤、16例微腺瘤和1例异位生长激素释放激素(GHRH)病例。115例患者接受了手术,其中74例被认定为治愈。11例患者接受了垂体放疗,其中4例未治愈该疾病。溴隐亭治疗的患者中12%有效,长效兰瑞肽治疗的患者中73%有效,长效奥曲肽治疗的患者中58%有效。7例患者检测出其他恶性肿瘤。11例患者在随访期间死亡。
我们地区可能存在肢端肥大症诊断不足的情况,尤其是在男性中。近年来,当有MRI检查时,我们观察到了更好的诊断机会。这伴随着手术和药物治疗更好的结果以及对该疾病并发症更好的控制。