Abstract：
Acromegaly is described as the oversecretion of growth hormone (GH) and, subsequently, insulin-like growth factor 1 (IGF-1), ascribed in most cases to a pituitary adenoma. This disease presents a progressive disfigurement, along with other systemic manifestations, which altogether diminishes the quality of life in the patients. Prolonged exposure to abnormally high levels of GH and IGF-1 levels results in cardiovascular, cerebrovascular, and pulmonary dysfunction which overall produces a fall in life expectancy. Timely diagnosis and further treatment decreased the mortality rate of the patients and showed an improvement in the quality of life. Surgical procedures, advanced radiation therapy tools, and the availability of pharmacological compounds that act on pituitary growth hormone-producing cells have enabled an improved approach to treating the disease. Pharmacological treatment is currently an important management option, and it may also be the first-line treatment in patients with acromegaly who do not benefit from or are ineligible for first-line surgical procedures. From its inception until 2021, we used a comprehensive search strategy on Medline/PubMed, Scopus, Embase, Web of Science, and the Cochrane Library electronic databases. All human research articles and review articles published in English were considered for the review. In this review, we describe the clinical implications and management of patients with acromegaly, consisting of scientific improvements underlying the developing understanding of pathogenesis and diagnosis, associated comorbidities and mortality rate with the disease, and major improvements in the treatment of the disease, along with novel strategies including quality of life and patient-reported outcomes.
摘要：
肢端肥大症被描述为生长激素(GH)的过度分泌，随后,胰岛素样生长因子1（IGF-1），在大多数情况下归因于垂体腺瘤。这种疾病呈现进行性毁容，以及其他系统性表现，这完全降低了患者的生活质量。长时间暴露于异常高水平的GH和IGF-1水平会导致心血管疾病，脑血管,和肺功能障碍，总体上导致预期寿命下降。及时诊断和进一步治疗，降低了患者的死亡率，并显示出生活质量的改善。外科手术,先进的放射治疗工具，以及作用于垂体生长激素产生细胞的药物化合物的可用性使治疗该疾病的方法得到了改善。药物治疗是目前重要的管理选择,对于不能从一线手术中获益或不符合一线手术条件的肢端肥大症患者,它也可能是一线治疗.从成立到2021年，我们在Medline/PubMed上使用了全面的搜索策略，Scopus,Embase,WebofScience,和Cochrane图书馆电子数据库.所有以英语发表的人类研究文章和评论文章都被考虑用于评论。在这次审查中,我们描述了肢端肥大症患者的临床意义和管理，包括对发病机理和诊断的发展理解的科学改进，与疾病相关的合并症和死亡率，以及疾病治疗的重大改进，以及包括生活质量和患者报告结局在内的新策略。
