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目的 探讨男性催乳素大腺瘤的临床特点、治疗方法与疗效的关系以及预后因素。方法 回顾性分析103例男性催乳素大腺瘤患者临床特点、不同治疗方式对治疗效果的影响,并初步探讨影响预后因素。结果 (1)男性催乳素大腺瘤最常见的症状是性欲或性功能减退,其次是头痛和视力减退。(2)药物治疗的患者57 8% 达到完全缓解,而单纯手术治疗仅有5 7%的患者完全缓解(P<0 001)。手术治疗不能完全缓解的患者采取药物、放疗以及两者联合治疗, 3种治疗的疗效差异无统计学意义(P=0 498)。(3)肿瘤存在侵袭性的患者较无侵袭性的患者预后差(P=0 03), 疗效不同的患者在年龄、病程、肿瘤大小、治疗前血催乳素水平以及是否存在垂体卒中方面无明显差异。结论 男性催乳素大腺瘤应首选药物治疗。肿瘤存在侵袭性是其预后不良因素。
Objective To investigate the clinical characteristics of male prolactin large adenoma, the relationship between treatment and efficacy and prognostic factors. Methods A retrospective analysis of 103 cases of male patients with prolactin large adenoma clinical features, different treatment methods on the treatment effect, and preliminary study of prognostic factors. Results (1) The most common symptom of prolactinoma in men is sexual desire or sexual dysfunction, followed by headache and vision loss. (2) 57.8% of the patients in the treatment group achieved complete remission, while only 57% of the patients in the simple operation group achieved complete remission (P <0.001). Surgical treatment can not be completely relieved patients taking drugs, radiotherapy and a combination of the two, the efficacy of the three treatment was no significant difference (P = 0 498). (3) The prognosis of patients with invasive tumor was worse than that of non-invasive group (P = 0.03). There was no significant difference in age, duration of disease, tumor size, blood prolactin level before treatment and whether there was any pituitary apoplexy difference. Conclusion Male prolactin large adenoma should be the preferred drug treatment. The aggressiveness of the tumor is a poor prognostic factor.