Neurological Surgery 脳神経外科43巻1号

2015年01月発行

総説

先端巨大症の最新治療

著者： 川俣貴一¹ 天野耕作¹ 岡田芳和¹

所属機関： ¹東京女子医科大学脳神経外科

ページ範囲：P.17 - P.28

Ⅰ．はじめに
　先端巨大症はその特有な容貌や四肢末端の変化の問題にとどまらず糖尿病，高血圧，心疾患，さらには呼吸器系や消化器系などの合併症を来し，適切な治療がなされなければ死亡率は健常者の2〜3倍となり約10年短命とされている^4,66)．逆に適切な治療がなされ，growth hormone（GH）分泌やinsulin-like growth factor-1（IGF-1）値を正常化すれば，死亡率は健常人と同等になるとされている^22,26)．よって治療は極めて重要である．
　先端巨大症の治療はこれまで外科治療が第1選択とされ，それは基本的に現在も同様だが，薬物療法の進歩とともにやや変化がみられ一部の症例においてはソマトスタチン誘導体を優先することもある⁴⁶⁾．一方で外科治療の進歩も著しく，最近の10年間をみても大きく変貌を遂げているのが実情である．本稿ではこのような最近の知見も踏まえ先端巨大症の治療の現状を解説する．

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