垂体卒中临床特征和治疗的年龄相关差异:一项队列研究。

IF 5.3 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Esteban Cordero Asanza, Antonio Biroli, Carlos Pérez-López, Marta Araujo-Castro, Rosa Cámara, Fernando Guerrero-Pérez, Almudena Vicente, Cristina Lamas, Guillermo Serra, Ana Irigaray Echarri, M Dolores Ollero, Inmaculada González Molero, Rocío Villar-Taibo, María Dolores Moure Rodríguez, Pablo García Feijoo, Víctor Rodríguez Berrocal, Noelia Sánchez, Alba Gutiérrez Hurtado, Vanessa Capristan-Díaz, Andreu Simó-Servat, Marta Gallach, Eva Safont Pérez, Victoria González Rosa, Soralla Civantos Modino, Edelmiro Menéndez Torre, Anna Aulinas, Pedro Iglesias, Juan J Diez, Verónica Rodríguez-Hernández, Albert Puig-Pérez, Elisa Blangini, Ignacio Bernabéu, Cristina Álvarez-Escolá, Silvana Sarria-Estrada, Manel Puig-Domingo, Fuat Arikán Abelló, Elena Martínez-Sáez, Betina Biagetti
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引用次数: 0

摘要

背景:垂体性中风(PA)是一种由脑垂体出血或梗死引起的罕见急性疾病。本研究旨在评估老年PA患者的临床特征、管理和结局。方法:我们对来自西班牙18家医院的301例PA患者进行了一项回顾性、多中心研究(2010-2023)。分析数据在人口统计学、临床表现、治疗方法和结果方面的差异。结果:年龄≥65岁的患者(n=116, 38.5%)比年轻患者(n=185, 61.5%)有更多的合并症。两组患者的临床表现无显著差异,包括垂体卒中评分和影像学表现,但脑神经麻痹的发生率较高(46.2比64.9%;P =0.02)。手术治疗(n=209)和保守治疗(n=92)两组之间的治愈率相似(保守治疗:年轻29.9% vs年长32.8%;p = 0.51)。组织病理学分析显示,≥65岁的患者坏死更多(66.7% vs. 80.6%;P = 0.04)。手术切除率和包括死亡率在内的结果在不同年龄组具有可比性。结论:尽管老年患者的合并症和症状更严重,但年轻患者和老年患者的PA管理和结果具有可比性。组织病理学结果提示肿瘤生物学中潜在的年龄相关差异,值得进一步研究。MRI是诊断的首选,特别是在老年患者中,因为缺血性坏死的PA可能在没有高级影像学检查的情况下无法诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Age-related differences in the clinical features and management of pituitary apoplexy: a cohort study.

Background: Pituitary apoplexy (PA) is a rare and acute condition resulting from hemorrhage or infarction of the pituitary gland. This study aimed to assess clinical characteristics, management, and outcomes of PA in patients aged <65 and ≥65 years using data from a Spanish multicenter cohort.

Methods: We conducted a retrospective, multicenter study (2010-2023) of 301 PA patients from 18 Spanish hospitals. Data were analyzed for differences in demographics, clinical presentation, treatment approach, and outcomes.

Results: Patients aged ≥65 years (n = 116, 38.5%) had more comorbidities, compared to younger patients (n = 185, 61.5%). No significant differences were observed in clinical presentation, including PA Score and radiological findings except for higher frequency of cranial nerve palsy (46.2 vs. 64.9%; P = .02) in older patients. Surgical (n = 209), and conservative (n = 92) treatment rates were similar between groups (conservative: 29.9 younger vs. 32.8% older; P = .51). Histopathological analysis revealed more necrosis in patients aged ≥65 years (66.7 vs. 80.6%; P = .04). Surgical resection rates and outcomes including mortality were comparable across age groups.

Conclusions: PA management and outcomes were comparable in younger and older patients, despite greater comorbidities and more severe symptoms in older individuals. Histopathological findings suggest potential age-related differences in tumor biology, warranting further research. MRI would be preferred for diagnosis, particularly in older patients, as ischemic necrotic PA may be undiagnosed without advanced imaging.

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来源期刊
European Journal of Endocrinology
European Journal of Endocrinology 医学-内分泌学与代谢
CiteScore
9.80
自引率
3.40%
发文量
354
审稿时长
1 months
期刊介绍: European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.
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