末端肥大症に対する経蝶形骨洞手術成績の臨床的ならびに内分泌学的検討 : 特にsomatomedin-C値の測定意義について

概要

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Fourteen patients with acromegaly who had undergone transsphenoidal surgery were followed for 1 to 7 years (average, 4.3 years). Pre- and postoperative growth hormone (GH) levels, changes in the GH response to thyrotropin releasing hormone (TRH) tolerance testing, and the correlation between clinical improvement and postoperative GH and somatomedin-C levels were studied. Clinical improvement was assessed by scoring of the pre- and postoperative symptoms. A significant correlation was found between the postoperative GH and somatomedin-C levels (p<0.01). All patients with postoperative somatomedin-C levels of less than 2 IU/ml, including one of the three patients whose postoperative GH levels were between 5 and 10 ng/ml, showed clinical improvement. Normal responses to TRH testing were rare and were poorly correlated with clinical improvement. These results suggest that somatomedin-C is more useful than GH in predicting clinical improvement following surgery for acromegaly.
日本脳神経外科学会の論文
1988-03-15