课件：垂体瘤术后激素替代.ppt

主要经营：网络软件设计、图文设计制作、发布广告等 公司秉着以优质的服务对待每一位客户，做到让客户满意！ 致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求 * * The vertical bars indicate the 95% confidence interval (CI) for the mean values shown. This study consisted of the follow-up of 85 GH-deficient adults? who completed the Nottingham Health Profile (NHP) and the Psychological? General Well-Being Schedule (PGWB) self-rating questionnaires in 1992, as? part of a 12-month double-blind randomized study of GH replacement. In? 2001 we attempted to contact all 85 patients and asked them to complete? the two questionnaires again. Follow-up data were obtained in 61 patients.? Both the NHP and the PGWB give a total score and? subsection scores for six specific areas of QoL. A high score correlates? with increased morbidity in the NHP, and with reduced morbidity in the? PGWB. 仅用于严重GH缺乏或明显骨质疏松 ?起始：小剂量(0.15-0.3mg iH. HS)(老年人0.1mg/d) ?剂量调节：个体化（根据临床反应和IGF-1）（年龄轻/ IGF-1低/雌激素激素替代可能增加GH剂量；年龄老/ IGF-1高/停雌激素激素/用雄激素/血糖升高/副作用时减少GH剂量） ?4-6月调整1次剂量，终剂量很少超过1mg Qd （以最小维持量维持） (1mg=3iu Adapted from Cook et al. J Clin Endocrinol Metab 1999;84:3956–60 GH-deficient women treated with GH and receiving oral oestrogen require twice as much GH to maintain serum IGF-I levels in the upper part of the normal range as women receiving transdermal oestrogen. This figure shows the time course of GH dose (μg/kg/day) and IGF-I levels (ng/ml) in a patient who was switched from oral to transdermal oestrogen during her course of treatment. Within 2 weeks of changing the route of administration, the patient complained of adverse effects due to GH excess (muscle and joint aching) and had an elevated IGF-I level. After reduction of the GH dose to half of that previously used when on oral oestrogen, symptoms of GH excess were relieved and IGF-I was normalized. Thus, if oestrogen is replaced transdermally in women, GH requirements are much less than when receiving oral oestrogen therapy. The effect of oral oestrogen on liver IGF-I production is proba