泌乳素腺瘤伽玛刀治疗后早期内分泌功能的改变及意义.docVIP

泌乳素腺瘤伽玛刀治疗后早期内分泌功能的改变及意义 沈光建，许民辉，邹咏文，耿明英，李飞鹏 （第三军医大学大坪医院野战外科研究所神经外科,重庆 400042） 摘 要： 目的 探讨泌乳素腺瘤患者伽玛刀治疗后早期内分泌功能的变化规律及意义。方法 对有完整近期随访资料的27例患者进行回顾分析，调查其临床症状和泌乳素（PRL）水平在治疗后6个月的动态变化，并评估该变化可能的临床意义。结果　在随访的6个月中，临床症状短暂或持续好转者24例（89%），PRL水平短暂或持续降低21例（78%）。临床症状好转和PRL下降主要发生于在治疗后前2个月。临床症状好转率及PRL水平在治疗后前2个月与其他月份间比较有显著差异（P 0.05）。结论 泌乳素腺瘤伽玛刀治疗后内分泌功能紊乱的改善在2个月内更为显著，应被视为育龄女性着孕或避孕的重点时期之一。 关键词：伽玛刀；泌乳素腺瘤；内分泌功能 中图法分类号： 文献标识码：A The changes of endocrinal function for prolactinoma and their roles in early stage after gamma knife radiosrugery SHEN Guang-jian, XU Min-hui, ZHOU Yong-wen，GENG Ming-ying，LI Fei-peng （Neurosurgical department, Daping hospital, Third Military Medical University, Chongqing 400042，China） Abstract Objective To explore the changes of endocrinal function and their roles in early stage for prolactinoma after gamma knife radiosurgery (GKRS). Methods 27 patients with intact early stage followed-up data were reviewed. The dynamical change for clinical syndrome and prolacin level during 6 months after GKRS were investigated. The possible clinical roles for the changes was evaluated. Results During 6 months after GKRS, the clinical syndrome was improved in 24 patients（89%） and PRL level decreased in 21 patients （78%）transiently or persistently. The improvement in syndrome and the reduction in PRL level occurred mostly in the first two month after GKS. In Ｘ２ and t test, there was significant difference between the first or second month and most of other month after GKRS on improvement　rate in syndrome and PRL level. Conclusions Endocrinal malfunction of prolactinoma can be ameliorated more significantly first two month after GKS, which should be regarded as one of key-stages on pregnancy or contraception for the female in genital period. Key words: gamma knife radiosurgery, prolactinoma, endocrinological function 泌乳素腺瘤是最常见的垂体肿瘤，临床上主要表现为肿瘤的占位压迫和内分泌功能紊乱，相关的治疗也主要针对于此。放射外科虽已成为治疗泌乳素腺瘤的重要手段之一[1]，但其在改善内分泌功能紊乱中的作用并不显著。目前的文献报道大多着眼于中、长期结果，早期的内分泌功能变化由于被认为实际意义有限而重视不够，故泌乳素腺瘤