Pumarino H, Oviedo S, Michelsen H, Campino C
Departamento de Medicina, Facultad de Medicina, Universidad de Chile (Division Norte), Hospital José Joaquín Aguirre, Santiago.
Rev Med Chil. 1991 Aug;119(8):897-907.
50 patients with autonomous growth hormone excess (48 with adult acromegaly and 2 with gigantism) were studied between 1966 to 1986 (2.38 pts/year). Characteristic clinical presentation, an increase in growth hormone (GH) uninhibited by glucose, and/or hyperphosphemia and hyperhydroxiprolinuria were present in all patients. No cases of hypercalcemia were recorded. Phosphemia was increased in 55.8%, alkaline phosphatases in 61.7%, calciuria in 26.9% and hydroxyprolinuria in 74.2% of the patients. Basal GH was over 5 ng/ml (89.9 DS +/- 170.9) in 42 pts, and in 37 was not suppressed after glucose administration, 38% had an increased (paradoxical response) and 62% a flat response (less than 50% change of basal values). TRH test was performed in 14 patients, 8 presented an increase in GH titer. Hyperprolactinemia was seen in 4 of 12 patients in whom this hormone was measured. The size of the sella turcica was increased in 93%, and although the larger sellar size correlated to higher levels of GH, correlation was not significant. 20% of the pts had rheumatological disease, 14% goiter, 12% cardiac disease, 26.5% had diastolic hypertension and 4% renal lithiasis (hypercalciuric pts). 38% had hyperglycemia with a diabetic glucose tolerance test and 18% had non-diabetic abnormal glucose tolerance test.
1966年至1986年期间对50例自主分泌生长激素过多的患者（48例成年肢端肥大症患者和2例巨人症患者）进行了研究（每年2.38例）。所有患者均有典型的临床表现、葡萄糖不能抑制生长激素（GH）升高和/或高磷血症及高羟脯氨酸尿症。未记录到高钙血症病例。55.8%的患者血磷升高，61.7%的患者碱性磷酸酶升高，26.9%的患者尿钙升高，74.2%的患者羟脯氨酸尿升高。42例患者基础GH超过5 ng/ml（89.9 DS±170.9），37例患者葡萄糖给药后未被抑制，38%的患者出现升高（矛盾反应），62%的患者呈平坦反应（基础值变化小于50%）。对14例患者进行了促甲状腺激素释放激素（TRH）试验，8例患者GH滴度升高。在检测该激素的12例患者中，4例出现高催乳素血症。93%的患者蝶鞍增大，虽然蝶鞍增大与较高的GH水平相关，但相关性不显著。20%的患者有风湿性疾病，14%的患者有甲状腺肿，12%的患者有心脏病，26.5%的患者有舒张期高血压，4%的患者有肾石症（高钙尿症患者）。38%的患者糖耐量试验显示高血糖，18%的患者糖耐量试验异常但非糖尿病。
