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[促甲状腺素分泌型垂体腺瘤患者术前短效奥曲肽治疗的临床特征及结果]

[Clinical characteristics and outcomes of preoperactive short-acting octreotide treatment in patients with thyrotropin-secreting pituitary adenomas].

作者信息

Xu J, Li Z, Guo Y, Liang D, Zhong L Y

机构信息

Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2021 Apr 1;60(4):345-349. doi: 10.3760/cma.j.cn112138-20200428-00433.

Abstract

To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism. A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated. The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT is a crucial factor affecting the efficacy of octreotide.

摘要

探讨垂体促甲状腺素分泌腺瘤患者的临床特征,评估术前短效奥曲肽治疗对甲亢的疗效。对2008年1月至2018年1月在北京天坛医院确诊的40例垂体促甲状腺素腺瘤患者进行回顾性分析。对其一般资料、实验室检查及影像学表现进行回顾分析,评估术前奥曲肽对甲亢的临床疗效。40例患者(男∶女 = 24∶16)发病年龄为(30.5±5.1)岁。其中35例(87.5%)为大腺瘤。最常见症状为甲状腺高代谢综合征,其次为头痛、头晕、视野缺损及性腺功能减退。30例患者(75%)在奥曲肽治疗后3~5天内甲状腺功能恢复正常。奥曲肽总有效率为90.0%。有效累积剂量超过10次的患者治疗前游离甲状腺素(FT)水平显著高于累积剂量小于10次的患者。甲状腺高代谢综合征和垂体占位效应是促甲状腺素分泌腺瘤最常见的临床表现。术前奥曲肽治疗可有效控制甲亢。FT水平是影响奥曲肽疗效的关键因素。

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