Fernández Real J M, Villabona C M, Montaña E, Acebes J J, Ricart W, Sahún M, Gómez J M, Soler J
Servicio de Endocrinología, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.
Med Clin (Barc). 1991 Apr 13;96(14):521-4.
From a neurological standpoint, pituitary apoplexy (PA) is a well defined syndrome. There are few systematic studies addressing pituitary hormone secretion after a PA episode. The aim of the present study was to assess the frequency and degree of endocrine dysfunction due to PA.
In 17 consecutive patients, the secretion of growth hormone (GH), the pituitary-adrenal axis status, thyrotropin (TSH), prolactin and gonadotropins (LH, FSH) were evaluated after the administration of insulin, thyrotropin releasing hormone (TRH) and gonadotropin-releasing hormone (LHRH) after an episode of PA. 20-90 days after surgery the measurements were repeated. Antidiuretic hormone (ADH) was measured by plasma/urine osmolality after water deprivation and, in some cases, by administration of hypertonic saline.
The most commonly found deficiency was that of GH (84%), which in two cases resulted in cure of acromegaly, followed by that of LH (78%). Pituitary-adrenal dysfunction was improved in two patients after surgery. In all cases except one there was a reduced secretion of at least two hormones. If serum prolactin was reduced, the rest of pituitary function was usually impaired. In one case, permanent diabetes insipidus developed after PA. The prevalence of PA in pituitary adenomas was 9%.
Pituitary hormone secretion after a PA episode is almost invariably impaired. This impairment may be reversed after surgery. Hypoprolactinemia is an indicator of pituitary hypofunction.
从神经学角度来看，垂体卒中（PA）是一种明确的综合征。很少有系统研究探讨垂体卒中发作后的垂体激素分泌情况。本研究的目的是评估垂体卒中导致的内分泌功能障碍的频率和程度。
对17例连续患者，在垂体卒中发作后，给予胰岛素、促甲状腺激素释放激素（TRH）和促性腺激素释放激素（LHRH）后，评估生长激素（GH）分泌、垂体 - 肾上腺轴状态、促甲状腺激素（TSH）、催乳素和促性腺激素（LH、FSH）。术后20 - 90天重复测量。抗利尿激素（ADH）通过禁水后血浆/尿渗透压测量，在某些情况下，通过给予高渗盐水测量。
最常见的激素缺乏是GH（84%），其中2例导致肢端肥大症治愈，其次是LH（78%）。两名患者术后垂体 - 肾上腺功能障碍有所改善。除1例患者外，所有患者至少有两种激素分泌减少。如果血清催乳素降低，垂体其他功能通常也受损。1例患者垂体卒中后发生永久性尿崩症。垂体腺瘤中垂体卒中的发生率为9%。
垂体卒中发作后垂体激素分泌几乎总是受损。这种损害在手术后可能会逆转。低催乳素血症是垂体功能减退的一个指标。
