Maruyama K, Muneyuki M, Kojima T, Hashimoto H, Oi Y, Okuda M, Kurioka T, Fujita Y, Konishi K
Anesth Analg. 1987 Aug;66(8):746-50.
During transsphenoidal surgery, serum growth hormone (GH) and serum glucose levels were measured in five acromegalic patients with diabetes or glucose intolerance, three acromegalic patients without diabetes or glucose intolerance, and six patients with prolactinoma. Preoperative steroid administration produced a significant increase in serum glucose level in acromegalic patients with diabetes or glucose intolerance, whereas in the other two groups no significant change in serum glucose level was found. After surgery started, there was a statistically significant increase in serum glucose level above baseline levels in all three groups. Serum GH levels decreased after commencement of surgery in acromegalic patients, and tumor manipulation did not produce a statistically significant increase in serum GH levels. Simultaneous increases in serum glucose and serum GH levels upon tumor manipulation did not occur in any group. We conclude that preoperative steroid administration in patients with high serum levels of GH in association with diabetes or glucose intolerance increases serum glucose levels, and that, after commencement of surgery, GH has only a minor role in the changes of serum glucose levels.
在经蝶窦手术过程中，对5例患有糖尿病或葡萄糖不耐受的肢端肥大症患者、3例无糖尿病或葡萄糖不耐受的肢端肥大症患者以及6例催乳素瘤患者测定了血清生长激素（GH）和血清葡萄糖水平。术前给予类固醇使患有糖尿病或葡萄糖不耐受的肢端肥大症患者的血清葡萄糖水平显著升高，而在其他两组中未发现血清葡萄糖水平有显著变化。手术开始后，所有三组的血清葡萄糖水平均较基线水平有统计学意义的显著升高。肢端肥大症患者手术开始后血清GH水平下降，肿瘤操作未使血清GH水平有统计学意义的显著升高。任何一组在肿瘤操作时均未出现血清葡萄糖和血清GH水平同时升高的情况。我们得出结论，术前对血清GH水平高且伴有糖尿病或葡萄糖不耐受的患者给予类固醇会使血清葡萄糖水平升高，并且手术开始后，GH在血清葡萄糖水平变化中仅起次要作用。
