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目的:探究奥曲肽敏感试验预测生长抑素受体配体(somatostatin receptor ligands, SRLs)治疗活动性肢端肥大症的临床应用价值。方法:回顾性分析2011年至2020年间76例未接受过放射治疗的活动性肢端肥大症患者的临床资料,所有患者均在晨起空腹状态下皮下注射短效奥曲肽100 μg,分别在0、2、4、6和8 h采血测定血清生长激素(GH)水平,所有患者均接受SRLs治疗至少3个月。SRLs治疗有效的标准为:治疗后血清随机GH80%定义为GH有效;治疗后血清胰岛素样生长因子Ⅰ(IGF-Ⅰ)50%定义为IGF-Ⅰ有效;同时满足GH和IGF-Ⅰ有效的标准定义为GH和IGF-Ⅰ均有效。结果:奥曲肽敏感试验中基线GH为15.00(6.38,34.20)μg/L,血清GH达到谷值的时间为(3.65±1.65)h,GH谷值为1.47(0.50,4.19)μg/L,GH抑制率为89.12%(72.71%,95.09%)。奥曲肽敏感试验中GH抑制率为89.32%时,曲线下面积(AUC)为0.74,预测GH有效的敏感度为81.80%,特异度为66.00%;GH抑制率为93.14%时,AUC为0.64,预测IGF-Ⅰ有效的敏感度和特异度分别为50.00%、75.60%;GH抑制率为90.71%时,AUC为0.78,预测GH和IGF-Ⅰ同时有效的敏感度为83.30%,特异度为70.00%。GH/IGF-Ⅰ有效组较GH/IGF-Ⅰ无效组奥曲肽敏感试验中GH谷值更低、GH抑制率更高、IGF-Ⅰ下降率更高、治疗后IGF-Ⅰ/ULN比值更低(n P<0.05)。n 结论:奥曲肽敏感试验中GH抑制率可以用来预测SRLs治疗垂体GH腺瘤的疗效,诊断界值为90.71%时敏感度和特异度最高。“,”Objective:To explore the value of octreotide suppression test(OST) in predicting the efficacy of somatostatin receptor ligands(SRLs) in the treatment of active acromegaly.Methods:The clinical data of 76 patients with active acromegaly from 2011 to 2020 was retrospectively analyzed. OST was carried out as follows: After an overnight fasting and baseline sampling of growth hormone(GH), 100 μg octreotide was subcutaneously injected, and sampling for GH was obtained every 2 hours for 8 hours. All patients were treated with SRLs for at least 3 months. A good GH response is defined as a post-treatment random GH80% fall compared with the baseline GH. A good insulin-like growth factor Ⅰ(IGF-Ⅰ) response is defined as IGF-Ⅰ50% reduction compared with the baseline. If both GH and IGF-Ⅰ fulfill the criteria of a good response, it is defined as a good GH and IGF-Ⅰ response.Results:The baseline level of GH during OST was 15.00(6.38, 34.20) μg/L, the median time to reach the nadir GH was(3.65±1.65) hours, and the nadir GH level was 1.47(0.50, 4.19) μg/L. The median GH suppression rate was 89.12%(72.71%, 95.09%). When the cutoff value of GH suppression rate in predicting a good GH response was 89.32%, the area under the curve(AUC) was 0.74, with a sensitivity of 81.80% and specificity of 66.00%. When the cutoff value of GH suppression rate in predicting a good IGF-Ⅰ response was 93.14%, the AUC was 0.64, with a sensitivity of 50.00% and specificity of 75.60%. When the GH suppression rate was 90.71%, the AUC was 0.78, with the sensitivity of 83.30% and specificity of 70.00% in predicting a good GH and IGF-Ⅰ response. Compared with GH/IGF-Ⅰ non-responders, GH/IGF-Ⅰ responders displayed lower nadir GH during OST, higher GH suppression rate and IGF-Ⅰ reduction rate, and lower ratio of IGF-1 to ULN( n P<0.05).n Conclusion:GH suppression rate during the OST is a valuable predictor to evaluate the efficacy of SRLs in patients with acromegaly, with the highest sensitivity and specificity when the cutoff value is 90.71%.