动脉瘤性蛛网膜下腔出血后的垂体功能减退
Pituitary deficiency following aneurysmal subarachnoid haemorrhage.
作者信息
Kreitschmann-Andermahr I, Hoff C, Niggemeier S, Pruemper S, Bruegmann M, Kunz D, Matern S, Gilsbach J M
机构信息
Department of Neurosurgery, University Hospital, Aachen University, Aachen, Germany.
出版信息
J Neurol Neurosurg Psychiatry. 2003 Aug;74(8):1133-5. doi: 10.1136/jnnp.74.8.1133.
OBJECTIVE
To investigate the incidence and severity of pituitary insufficiency after aneurysmal subarachnoid haemorrhage.
METHODS
Pituitary function was tested in a series of patients more than 12 months but less than 60 months after aneurysmal subarachnoid haemorrhage using a combined TRH-LHRH-arginine test and the insulin tolerance test, to elucidate possible deficits in the gonadotrophic, somatotrophic, thyreotrophic, and corticotrophic hormonal axes.
RESULTS
Of 21 patients screened, nine (43%) showed deficiencies of at least one pituitary hormone axis. Four patients had corticotrophin deficiency, one had partial growth hormone deficiency, two had severe growth hormone deficiency, and two had severe growth hormone deficiency plus corticotrophin deficiency.
CONCLUSIONS
Persistent pituitary dysfunction may be more common after aneurysmal subarachnoid haemorrhage than has so far been recognised and warrants further investigation, given the possibility that some health and neurobehavioural problems in these patients could result from hormone deficiency.
目的
研究动脉瘤性蛛网膜下腔出血后垂体功能减退的发生率及严重程度。
方法
对一系列动脉瘤性蛛网膜下腔出血后12个月以上但不足60个月的患者进行垂体功能测试，采用促甲状腺激素释放激素-促黄体生成素释放激素-精氨酸联合试验和胰岛素耐量试验，以阐明促性腺激素、生长激素、促甲状腺激素和促肾上腺皮质激素轴可能存在的缺陷。
结果
在筛查的21例患者中，9例（43%）至少有一个垂体激素轴功能减退。4例患者有促肾上腺皮质激素缺乏，1例有部分生长激素缺乏，2例有严重生长激素缺乏，2例有严重生长激素缺乏加促肾上腺皮质激素缺乏。
结论
动脉瘤性蛛网膜下腔出血后持续存在垂体功能障碍可能比目前所认识到的更为常见，鉴于这些患者的一些健康和神经行为问题可能由激素缺乏引起，因此值得进一步研究。
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