Centre for Endocrinology, Diabetes, and Metabolism, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, United Kingdom.
Endocr Rev. 2010 Jun;31(3):301-42. doi: 10.1210/er.2009-0033. Epub 2010 Jan 19.
Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing's disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients.
垂体疾病与死亡率增加有关，主要是由于血管疾病。控制皮质醇分泌和 GH 分泌过多（以及降低心血管风险因素）是库欣病和肢端肥大症患者降低死亡率的关键，这是回顾性的。对于肢端肥大症患者，IGF-I 的作用不太明确。性腺激素和特别是 ACTH 缺乏等垂体激素缺乏症（使用更高剂量的氢化可的松替代治疗）可能对垂体疾病患者的预后产生不利影响。垂体放疗是另一个与死亡率增加（特别是脑血管疾病）相关的因素。尽管由于治疗的改善，垂体疾病的标准化死亡率正在下降，但许多疾病的死亡率仍高于一般人群，因此需要采取进一步的措施。颅咽管瘤患者由于肿瘤本身和控制肿瘤生长的治疗而面临特别高的死亡风险；这是未来研究的一个关键领域，以便为这些患者优化治疗结果。
