Sakai Aya, Toga Hirohisa, Tachibana Osamu, Miwa Takaki
Department of Otorhinolaryngology-Head and Neck Surgery, Kanazawa Medical University.
Nihon Jibiinkoka Gakkai Kaiho. 2013 May;116(5):612-8. doi: 10.3950/jibiinkoka.116.612.
Acromegaly is caused by excessive secretion of growth hormone (GH) and presents with a variety of clinical manifestations, including facial disfigurement and abnormally large hands and feet, as well as diabetes mellitus, hypertension, and sleep-disordered breathing (SDB). Although SDB is known to be associated with serious symptoms, there have been few study reports, and no clear consensus has been reached regarding the method of assessment of individual treatments. We report herein on the results of surgical intervention with transsphenoidal surgery (TSS) for acromegaly and assessment of the treatment effect after the intervention. We studied 6 patients who received a diagnosis of acromegaly complicated with SDB and underwent TSS at our hospital. Polysomnography (PSG) was performed before and after TSS, and the polysomnograms were analyzed. We also examined changes in the levels of GH and insulin-like growth factor-1 (IGF-1) on blood biochemistry. In 6 cases of acromegaly with SDB, we were able to confirm endocrinologic improvement of TSS with blood biochemistry. However there was no meaningful improvement in the PSG index for SDB.
肢端肥大症由生长激素（GH）分泌过多引起，表现为多种临床表现，包括面部畸形、手脚异常增大，以及糖尿病、高血压和睡眠呼吸紊乱（SDB）。尽管已知SDB与严重症状相关，但研究报告很少，对于个体治疗的评估方法也尚未达成明确共识。我们在此报告经蝶窦手术（TSS）治疗肢端肥大症的手术干预结果及干预后治疗效果的评估。我们研究了6例被诊断为肢端肥大症合并SDB并在我院接受TSS的患者。在TSS前后进行多导睡眠图（PSG）检查，并对多导睡眠图进行分析。我们还检查了血液生化中GH和胰岛素样生长因子-1（IGF-1）水平的变化。在6例肢端肥大症合并SDB的病例中，我们能够通过血液生化证实TSS的内分泌改善。然而，SDB的PSG指数没有显著改善。
