Buchfelder M, Brockmeier S, Fahlbusch R, Honegger J, Pichl J, Manzl M
Neurochirurgische Klinik, Universität Erlangen-Nürnberg, FRG.
Horm Res. 1991;35(3-4):113-8. doi: 10.1159/000181885.
The long-term results of transsphenoidal adenomectomy and the incidence of possible recurrences were studied in 61 patients who had normal basal serum growth hormone (GH) levels 1 week after surgery. The patients were followed up for an average of 6.0 years (range: 1.5-14.0 years) by repeated measurements of GH, oral glucose tolerance testing (OGTT) and at the last follow-up visit also by assaying somatomedin C levels. In 4 of the patients, the basal GH levels had increased to values above 5 ng/ml. In 43 patients, a normal suppression of GH during an oral glucose load was observed shortly after surgery. In only 2 of these cases did a transiently inadequate suppression develop during the follow-up period, although clinical acromegaly did not recur and the somatomedin C levels remained normal. It is concluded that recurrence of active acromegaly is unlikely to occur in patients who achieve a normal glucose-induced suppression of GH levels shortly after adenomectomy. As such, an OGTT provides better prognostic information than basal human GH level measurements and may give a clearer and earlier indication of surgical success.
对61例术后1周基础血清生长激素（GH）水平正常的患者进行了经蝶窦腺瘤切除术的长期结果及可能复发率的研究。通过重复测量GH、口服葡萄糖耐量试验（OGTT），并在最后一次随访时检测生长介素C水平，对患者进行了平均6.0年（范围：1.5 - 14.0年）的随访。4例患者的基础GH水平升至5 ng/ml以上。43例患者术后不久口服葡萄糖负荷期间GH正常抑制。在这些病例中，随访期间仅2例出现短暂抑制不足，尽管临床肢端肥大症未复发且生长介素C水平保持正常。得出结论，腺瘤切除术后不久葡萄糖诱导的GH水平正常抑制的患者不太可能发生活动性肢端肥大症复发。因此，OGTT比基础人GH水平测量提供更好的预后信息，并且可能更清晰、更早地表明手术成功。
