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一大群肢端肥大症患者的肺功能评估。

Assessment of lung function in a large cohort of patients with acromegaly.

作者信息

Störmann Sylvère, Gutt Bodo, Roemmler-Zehrer Josefine, Bidlingmaier Martin, Huber Rudolf M, Schopohl Jochen, Angstwurm Matthias W

机构信息

Medizinische Klinik und Poliklinik IVKlinikum der Universität München und Lungentumorzentrum München, Germany.

Asklepios Klinik BirkenwerderAbteilung für Diabetologie, Birkenwerder, Germany.

出版信息

Eur J Endocrinol. 2017 Jul;177(1):15-23. doi: 10.1530/EJE-16-1080. Epub 2017 Apr 21.

Abstract

OBJECTIVE

Acromegaly is associated with increased mortality due to respiratory disease. To date, lung function in patients with acromegaly has only been assessed in small studies, with contradicting results. We assessed lung function parameters in a large cohort of patients with acromegaly.

DESIGN

Lung function of acromegaly patients was prospectively assessed using spirometry, blood gas analysis and body plethysmography. Biochemical indicators of acromegaly were assessed through measurement of growth hormone and IGF-I levels. This study was performed at the endocrinology outpatient clinic of a tertiary referral center in Germany.

METHODS

We prospectively tested lung function of 109 acromegaly patients (53 male, 56 female; aged 24-82 years; 80 with active acromegaly) without severe acute or chronic pulmonary disease. We compared lung volume, air flow, airway resistance and blood gases to normative data.

RESULTS

Acromegaly patients had greater lung volumes (maximal vital capacity, intra-thoracic gas volume and residual volume:  < 0.001, total lung capacity:  = 0.006) and showed signs of small airway obstruction (reduced maximum expiratory flow when 75% of the forced vital capacity (FVC) has been exhaled:  < 0.001, lesser peak expiratory flow:  = 0.01). There was no significant difference between active and inactive acromegaly. Female patients had significantly altered lung function in terms of subclinical airway obstruction.

CONCLUSIONS

In our cross-sectional analysis of lung function in 109 patients with acromegaly, lung volumes were increased compared to healthy controls. Additionally, female patients showed signs of subclinical airway obstruction. There was no difference between patients with active acromegaly compared with patients biochemically in remission.

摘要

目的

肢端肥大症与呼吸系统疾病导致的死亡率增加有关。迄今为止,仅在小规模研究中评估了肢端肥大症患者的肺功能,结果相互矛盾。我们在一大群肢端肥大症患者中评估了肺功能参数。

设计

采用肺活量测定法、血气分析和体容积描记法对肢端肥大症患者的肺功能进行前瞻性评估。通过测量生长激素和胰岛素样生长因子-I水平评估肢端肥大症的生化指标。本研究在德国一家三级转诊中心的内分泌门诊进行。

方法

我们前瞻性地测试了109例无严重急性或慢性肺部疾病的肢端肥大症患者(53例男性,56例女性;年龄24 - 82岁;80例患有活动性肢端肥大症)的肺功能。我们将肺容积、气流、气道阻力和血气与标准数据进行了比较。

结果

肢端肥大症患者的肺容积更大(最大肺活量、胸腔内气体容积和残气量:<0.001,肺总量:=0.006),并显示出小气道阻塞的迹象(呼出75%用力肺活量(FVC)时最大呼气流量降低:<0.001,呼气峰值流量较低:=0.01)。活动性和非活动性肢端肥大症之间无显著差异。女性患者在亚临床气道阻塞方面肺功能有显著改变。

结论

在我们对109例肢端肥大症患者肺功能的横断面分析中,与健康对照相比,肺容积增加。此外,女性患者显示出亚临床气道阻塞的迹象。活动性肢端肥大症患者与生化缓解患者之间无差异。

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