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治疗后的肢端肥大症和活动性库欣综合征中的生长激素缺乏。

Growth hormone deficiency in treated acromegaly and active Cushing's syndrome.

机构信息

Endocrinology, Univeristy of Brescia, Italy.

Endocrinology, Univeristy of Brescia, Italy.

出版信息

Best Pract Res Clin Endocrinol Metab. 2017 Feb;31(1):79-90. doi: 10.1016/j.beem.2017.03.002. Epub 2017 Mar 9.

Abstract

Growth hormone deficiency (GHD) in adults is characterized by reduced quality of life and physical fitness, skeletal fragility, increased weight and cardiovascular risk. It may be found in (over-) treated acromegaly as well as in active Cushing's syndrome. Hypopituitarism may develop in patients after definitive treatment of acromegaly, although the exact prevalence of GHD in this population is still uncertain because of limited awareness, and scarce and conflicting data so far available. Because GHD associated with acromegaly and Cushing's syndrome may yield adverse consequences on similar target systems, the final outcomes of some complications of both acromegaly and Cushing's syndrome may be further affected by the occurrence of GHD. It is still largely unknown, however, whether GHD in patients with post-acromegaly or active Cushing's syndrome (e.g. pharmacologic glucocorticoid treatment) may benefit from GH replacement. We review the diagnostic, clinical and therapeutic aspects of GHD in adults treated for acromegaly and in those with active Cushing's syndrome.

摘要

成年人生长激素缺乏症(GHD)的特征是生活质量和身体适应性降低、骨骼脆弱、体重增加和心血管风险增加。它可能在(过度)治疗的肢端肥大症以及活跃的库欣综合征中发现。尽管由于认识有限以及目前可用的稀缺和相互矛盾的数据,肢端肥大症患者在明确治疗后可能会发生垂体功能减退症,但这种情况下 GHD 的确切患病率仍不确定。由于与肢端肥大症和库欣综合征相关的 GHD 可能对类似的靶系统产生不良后果,因此这两种疾病的一些并发症的最终结果可能会进一步受到 GHD 的影响。然而,尚不清楚患有肢端肥大症后或活动性库欣综合征(例如药物性糖皮质激素治疗)的患者的 GHD 是否会从 GH 替代治疗中获益,这仍然在很大程度上是未知的。我们回顾了治疗肢端肥大症和活动性库欣综合征的成年人的 GHD 的诊断、临床和治疗方面。

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