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肢端肥大症患者用奥曲肽长效释放剂治疗后的生化和生活质量反应。

Biochemical and quality of life responses to octreotide-LAR in acromegaly.

机构信息

Neuroendocrinology Section, Department of Neurosurgery, Hospital Universitario de Caracas, Los Chaguaramos, Caracas, 1040, Dtto Capital, Venezuela,

出版信息

Pituitary. 2014 Dec;17(6):495-9. doi: 10.1007/s11102-013-0533-x.

DOI:10.1007/s11102-013-0533-x
PMID:24178448
Abstract

OBJECTIVES

AcroQoL is a questionnaire developed to assess quality of life in patients with acromegaly, covering physical and psychological dimensions. This study was designed to determine AcroQoL score changes and concentrations of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), before and after treatment with octreotide-LAR (oct-LAR) in acromegaly.

METHODS

Retrospective observational study of 28 acromegalic patients with a mean age of 45 years (range 28-64), evaluated over a 4-year period, before and during treatment with oct-LAR in clinical practice conditions.

RESULTS

Baseline AcroQoL score (53 ± 15) improved after oct-LAR treatment (70 ± 15) globally for the 28 patients (p < 0.001). Three patients in whom AcroQoL score did not improve over time had severe headaches, which did not disappear. In patients who normalized, both GH (<2.5 μg/L) and IGF-1, AcroQoL score increased on average by 22 points (p = 0.003); when GH and IGF-1 improved, but did not normalize, AcroQol score increased on average by 16 points (p = 0.008). In 6 patients with discordant results, AcroQol score tended to improve if IGF-1 normalized (n = 4, p = 0.066), but not if IGF-1 remained high.

CONCLUSION

Oct-LAR therapy in acromegaly improved quality of life scores in parallel to biochemical markers, except in patients with severe headaches. The AcroQoL questionnaire is an additional tool to establish therapeutic effectivity.

摘要

目的

AcroQoL 是一种专为评估肢端肥大症患者生活质量而开发的问卷,涵盖了生理和心理两个方面。本研究旨在确定奥曲肽长效释放剂(octreotide-LAR,oct-LAR)治疗前后肢端肥大症患者的 AcroQoL 评分变化和生长激素(GH)和胰岛素样生长因子 1(IGF-1)的浓度。

方法

这是一项回顾性观察研究,共纳入 28 例平均年龄为 45 岁(28-64 岁)的肢端肥大症患者,在临床实践条件下用 oct-LAR 治疗,随访 4 年。

结果

28 例患者的基线 AcroQoL 评分(53±15)在 oct-LAR 治疗后(70±15)整体得到改善(p<0.001)。3 例患者治疗过程中出现严重头痛且未缓解,AcroQoL 评分无改善。在 GH(<2.5μg/L)和 IGF-1 正常化的患者中,AcroQoL 评分平均增加 22 分(p=0.003);当 GH 和 IGF-1 改善但未正常化时,AcroQoL 评分平均增加 16 分(p=0.008)。在 6 例结果不一致的患者中,如果 IGF-1 正常化(n=4,p=0.066),AcroQoL 评分有改善趋势,但如果 IGF-1 仍偏高,则无改善趋势。

结论

除了伴有严重头痛的患者外,奥曲肽长效释放剂治疗肢端肥大症可改善患者的生活质量评分,与生化标志物改善情况一致。AcroQoL 问卷是评估治疗效果的附加工具。

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A prospective, multicentre study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting repeatable octreotide) in the primary therapy of patients with acromegaly.一项前瞻性多中心研究,旨在调查长效重复注射用奥曲肽(奥曲肽LAR)在肢端肥大症患者初始治疗中的疗效、安全性和耐受性。
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