摘要
目的利用术后3d内血清皮质醇水平预测库欣病患者经蝶窦入路肿瘤切除术后疗效。方法对象为北京协和医院2010年1月至2014年12月间手术治疗的275例库欣病患者，检测术后3d内清晨血皮质醇水平（将〈140nmol／L作为内分泌缓解标准），通过随访评估长期疗效。275例患者年龄11—73岁，平均36．5岁，其中男49例，女226例。结果275例中术后内分泌缓解201例，缓解率为73．1％。其中垂体大腺瘤17例，缓解8例，缓解率为47．1％；垂体微腺瘤及MRI阴性258例，缓解193例（74．8％）；43例术后复发入院行2次手术的患者，术后20例缓解（46．5％）。术后随访12—60个月，平均随访36个月，201例术后缓解的患者中8例于术后1～4年复发。结论利用术后3d内清晨血清皮质醇可以较好的预测手术治疗患者的长期疗效，但即使血清皮质醇水平〈140nmol／L仍有部分肿瘤复发，患者应终生随访。
Objective To predict the therapeutic effect of Cushing＇s disease after transsphenoidal surgery by using morning serum cortisol level. Methods The clinical data of 275 cases that had transsphenoidal surgery in Peking Union Medical College Hospital from 2010 to 2014 were analyzed retrospectively. Early morning serum cortisol level less than 140 nmol/L 3 days postoperation was usedto predict endocrinological remission. And long-term efficacy was evaluated by follow-up. Results Of the 275 patients, there were 49 males and 226 females; average age was 36. 5 years old. Remission wasconfirmed in 201 cases, the remission rate was 73.1%, and 8 cases recurrent duringfollow-up. There were 17 macroadenomas, theremission rate was 47. 1%; 258 microadenomas and MRI negative adenomas, the remission rate was 74. 8% . And 43 recurrent cases had reoperations; the remission rate was 46. 5%. Conclusion Early morningserum cortisol 3 days post operation can evaluate the effectof transsphenoidal surgery, but even if the level of cortisol is less than 140 nmol/L, there is still tumor recurrence. Patients should be follow-up for a lifetime.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第31期2458-2461,共4页
National Medical Journal of China
关键词
垂体腺瘤
库欣病
皮质醇
经蝶窦入路
手术
Pituitary adenoma
Cushing＇s disease
Cortisol
Transsphenoidal approach
Operation
