Vilar Lucio, Valenzuela Alex, Ribeiro-Oliveira Antônio, Gómez Giraldo Claudia M, Pantoja Doly, Bronstein Marcello D
Division of Endocrinology and Metabolism, Hospital das Clinicas, Federal University Medical School, Recife, Pernambuco, Brazil.
Pituitary. 2014 Jan;17 Suppl 1(Suppl 1):S11-7. doi: 10.1007/s11102-013-0536-7.
The current article provides a brief overview of the criteria for defining disease control in acromegaly.
This was a retrospective, narrative review of previously published evidence chosen at the author's discretion along with an illustrative case study from Latin America.
In the strictest sense, "cure" in acromegaly is defined as complete restoration of normal pulsatile growth hormone secretion, although this is rarely achieved. Rather than "cure", as such, it is more appropriate to refer to disease control and remission, which is defined mainly in terms of specific biochemical targets (for growth hormone and insulin-like growth factor-1) that predict or correlate with symptoms, comorbidities and mortality. However, optimal management of acromegaly goes beyond biochemical control to include control of tumour growth (which may be independent of biochemical control) and comprehensive management of the symptoms and comorbidities typically associated with the disease, as these may not be adequately managed with acromegaly-specific therapy alone.
本文简要概述肢端肥大症疾病控制的定义标准。
这是一篇回顾性叙述性综述,由作者自行选择先前发表的证据,并伴有一个来自拉丁美洲的实例研究。
从最严格的意义上讲,肢端肥大症的“治愈”定义为正常脉冲式生长激素分泌的完全恢复,尽管这种情况很少实现。与其说是“治愈”,不如说是疾病控制和缓解,这主要根据特定的生化指标(生长激素和胰岛素样生长因子-1)来定义,这些指标可预测症状、合并症和死亡率或与之相关。然而,肢端肥大症的最佳管理不仅仅是生化控制,还包括肿瘤生长的控制(这可能独立于生化控制)以及对通常与该疾病相关的症状和合并症的综合管理,因为仅靠肢端肥大症特异性治疗可能无法充分控制这些症状和合并症。