Holdaway I M
Department of Endocrinology, Greenlane Clinical Centre, Auckland City Hospital, Auckland, New Zealand.
Horm Res. 2007;68 Suppl 5:166-72. doi: 10.1159/000110617. Epub 2007 Dec 10.
Increased production of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in patients with acromegaly is associated with a twofold increase in mortality compared with the general population. The range of standardised mortality rates in various studies ranges from 1.2 to 3.6.
Multivariate analysis has indicated that post-treatment serum GH levels and, in a number of studies, serum IGF-I levels are the most powerful predictors of outcome. Normal IGF-I concentrations and random GH levels <2.5 microg/l measured by polyclonal radioimmunoassay result in optimal outcome. Other factors adversely influencing mortality include hypertension and a long interval between onset of the disorder and diagnosis.
Analysis of recent reports suggests that adoption of treatment guidelines with appropriate post-treatment target ranges for GH and IGF-I, together with the availability of newer methods to control GH oversecretion, has significantly improved patient outcomes.
与普通人群相比，肢端肥大症患者生长激素（GH）和胰岛素样生长因子-I（IGF-I）分泌增加，其死亡率增加两倍。各项研究中标准化死亡率范围为1.2至3.6。
多变量分析表明，治疗后血清GH水平以及在一些研究中血清IGF-I水平是预后最有力的预测因素。通过多克隆放射免疫测定法测得的IGF-I浓度正常且随机GH水平<2.5微克/升可产生最佳预后。其他对死亡率有不利影响的因素包括高血压以及疾病发作与诊断之间的间隔时间长。
近期报告分析表明，采用针对GH和IGF-I的具有适当治疗后目标范围的治疗指南，以及采用控制GH分泌过多的新方法，已显著改善了患者预后。
