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90例垂体生长激素(GH)瘤患者,首发症状以面容变丑、肢端肥大最多,为83例(92%)。28例(31%)视力明显减退,24例(26.7%)双眼或单眼颞侧或外上象限偏盲,合并糖尿病和糖耐量减退共33例(36.7%)。90例患者基础血清GH水平均>5μg/L,其中>80μg/L者34例。39例行3h100g葡萄糖抑制GH试验,18例行阿托品抑制GH试验,两组患者GH水平均不能被抑制到<5μg/L水平。88例患者行头颅CT检查均发现垂体瘤,90例患者经手术证实大腺瘤41例(45.6%),微腺瘤49例(54.4%)。肿瘤向鞍上池扩展者33例。术后33例患者接受放射治疗,术后或以后1~5年随诊中62.8%患者血清GH水平正常(<5μg/L),92.3%的患者GH水平较术前下降。7例患者视力增加或视野扩大。手术并发症发生率为8.9%(8例)。
In 90 patients with pituitary growth hormone (GH) tumors, the first symptoms were ugly face and acromegaly, with 83 cases (92%). Visual acuity decreased significantly in 28 cases (31%), hemianopia in the temporal or outer quadrant of both eyes or monocular eyes in 24 cases (26.7%), diabetes mellitus and impaired glucose tolerance in 33 cases (36.7%). Baseline serum GH levels were >5 μg/L in 90 patients, and 34 patients were >80 μg/L. 39 patients underwent 3h100g glucose inhibition GH test and 18 patients underwent atropine inhibition GH test. The GH levels in both groups could not be suppressed to <5μg/L level. Eighty-eight patients underwent cranial CT examination and found pituitary adenomas. Among the 90 patients, 41 (45.6%) had macroadenomas confirmed by surgery and 49 (54.4%) had microadenomas. Thirty-three cases of tumors extended to the suprasellar cistern. After the surgery, 33 patients received radiation therapy. 62.8% of the follow-up patients or 1 to 5 years later had normal serum GH levels (<5 μg/L), and 92.3% had lower GH levels than before surgery. Visual acuity increased or visual field was enlarged in 7 patients. The incidence of surgical complications was 8.9% (8 cases).