目的 探讨白细胞介素1α(IL-1α)基因多态性与颅内动脉瘤发生的关系。 方法 以2010年6月-2012年3月145例颅内动脉瘤患者和181例正常对照者为研究对象,采用聚合酶链反应-限制性片段长度多态性检测IL-1α-889C/T和+4845G/T多态性,统计分析基因多态性与颅内动脉瘤的相关性。 结果 IL-1α-889C/T位点:CT/TT基因型在颅内动脉瘤组中的频率为32.4%,显著高于其在对照组中的频率(21.5%),两组相比差异有统计学意义(χ2=4.90,P<0.05);T等位基因在颅内动脉瘤组中的频率为16.9%,显著高于其在对照组中的频率(10.8%),两组相比差异有统计学意义(χ2=5.17,P<0.05)。IL-1α+4845G/T多态性在两组人群中的分布差异无统计学意义(P>0.05)。 结论 IL-1α -889C/T多态性与颅内动脉瘤的发病有关,-889T等位基因可能是颅内动脉瘤的遗传易感基因。
【摘要】 目的 分析手术治疗垂体瘤患者长期临床恢复以及生活质量改善情况。 方法 回顾性分析2007年12月-2008年9月手术治疗的103例垂体瘤患者术前以及术后长期随访资料,使用SF-36量表对术前、术后患者生活质量进行评估,分析手术治疗前后患者症状、激素水平恢复情况以及生活质量改善情况,并进一步分析肿瘤大小、侵袭程度对术后生活质量的影响。 结果 术后头痛症状消失52例,视力改善76例,其他症状具有不同程度改善;术后SF-36生活质量评估结果显示,患者除精神健康外的7个维度(生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能)均有明显改善(P<0.05),不同肿瘤大小及侵袭程度的患者术后生活质量评分均无统计学意义(P>0.05),垂体功能完全恢复者生活质量评分高于垂体功能低下者(P<0.05)。 结论 显微手术治疗垂体瘤患者可明显改善患者的一般症状、提高患者的生活质量,单纯肿瘤的大小和侵袭程度对术后生活质量的影响程度较小,术后垂体功能的恢复程度明显影响患者的生活质量,垂体瘤术后患者的激素长期替代治疗尚需进一步加强。【Abstract】 Objective To analyze the long-term clinical recovery and quality of life (QoL) in patients with pituitary adenoma treated by microneurosurgery. Methods The clinical data of 103 patients undergoing microneurosurgery from December 2007 to September 2008 were retrospectively analyzed, health-related questionnairs (SF-36) were used to assess the QoL. The post-surgery recovery of symptoms, endocrine function, and QoL were compared with those of pre-surgery, then the correlation between tumor size, invasive behavior, and QoL were analyzed. Results Headache disappeared in 52 patients. Visual symptoms improved in 76 patients. Other symptoms were also improved. Seven concepts (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotioning) were improved after surgery (Plt;0.05). The eight health concepts of SF-36 showed no significant difference between patients with different tumor size and invasive behavior (Pgt;0.05). Differences were considered statistically significant between normal and abnormal pituitary function groups after surgery(Plt;0.05) in all concepts. Conclusion Microneurosurgical treatment can improve the general symptoms and the QoL. The tumor size and invasion have little influence on the QoL after surgery, but the improvement of hormone deficiency has influence on the QoL significantly. More attention should be given to the long-term hormone replacement therapy after the pituitary adenoma surgery.
Multi-disciplinary team (MDT) is increasingly applied in oncology and refractory diseases. In recent years, MDT has also been applied in diagnosis and treatment of pituitary adenoma and related diseases. This review summarizes the advantages and characteristics of the MDT diagnosis and treatment mode, and analyzes the application and effect of the MDT diagnosis and treatment mode in the Center of Pituitary Adenoma and Related Diseases, West China Hospital, Sichuan University. So far, it has shown that MDT has advantages such as it is professional, full of collaborative interaction, and efficient and optimized. It is a platform of multi-disciplinary cooperation and resources in the diagnosis and treatment of difficult diseases. Case discussion in MDT mode is conducive to timely selection of the best treatment options for patients with pituitary adenoma and related diseases, providing a good learning platform for doctors with different professional backgrounds, and promoting the improvement of professional diagnosis and treatment level of doctors in related departments. The development of MDT will help us to use limited medical resources efficiently, promote the medical team to be more specialized, optimize the diagnosis and treatment process, and improve the effectiveness of the treatment, for benefiting more patients with pituitary adenomas and related diseases.