Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.
Eur J Endocrinol. 2011 Jan;164(1):37-43. doi: 10.1530/EJE-10-0651. Epub 2010 Oct 6.
To assess frequency, symptoms and outcome of pituitary apoplexy (PA) among pituitary adenoma patients, to gain better insight into risk factors for bleeding into pituitary adenoma and to estimate the sequelae of PA by means of a matched control group.
By reviewing charts of 574 patients with pituitary adenoma, we analysed incidence, symptoms and outcome of PA and potential risk factors for developing PA by means of a control group (patients with pituitary adenoma without PA).
In total, 42 suffered from PA, all had macroadenomas; 30/217 male (14%) and 12/179 female (7%) macroadenoma patients, 32/194 patients with clinically non-functioning (16.5%) and 10/202 with clinically active (5.0%) macroadenoma were affected. Antithrombotic therapy predisposed patients to PA (P=0.026), diabetes mellitus and hypertension did not (P=1.00). Patients with PA and pituitary adenoma patients without PA had similar frequencies of hypopituitarism (45 vs 48%, P>0.05) and visual field defects (38 vs 55%, P>0.05), but ophthalmoplegia was significantly more common (76 vs 5%, P<0.001) in patients with PA. Nearly all patients were treated by surgery; most recovered from ophthalmoplegia, whereas visual function improved only moderately. Endocrine outcome was worse in patients with PA than in patients without PA.
Male sex and characteristics of the adenoma itself (especially tumour size and tumour type) rather than patient's cardiovascular risk factors such as diabetes and hypertension seem to predispose to PA; antithrombotic therapy may also be important.
评估垂体腺瘤患者垂体卒中（PA）的发生率、症状和转归，深入了解垂体腺瘤出血的危险因素，并通过匹配对照组评估 PA 的后遗症。
通过回顾 574 例垂体腺瘤患者的病历，我们分析了 PA 的发生率、症状和转归，以及通过对照组（无 PA 的垂体腺瘤患者）分析了发生 PA 的潜在危险因素。
共有 42 例发生 PA，均为大腺瘤；217 例男性中 30 例（14%），179 例女性中 12 例（7%）为大腺瘤患者，32 例无功能性（16.5%）和 10 例功能性（5.0%）大腺瘤患者中有 12 例发生 PA。抗血栓治疗使患者易发生 PA（P=0.026），糖尿病和高血压不会（P=1.00）。发生 PA 的患者与无 PA 的垂体腺瘤患者的垂体功能减退发生率相似（45%对 48%，P>0.05）和视野缺损发生率相似（38%对 55%，P>0.05），但 PA 患者的眼肌麻痹发生率明显更高（76%对 5%，P<0.001）。几乎所有患者均接受手术治疗；大多数患者的眼肌麻痹恢复，但视力功能仅略有改善。PA 患者的内分泌转归比无 PA 患者差。
男性性别和腺瘤本身的特征（尤其是肿瘤大小和肿瘤类型）而不是患者的心血管危险因素（如糖尿病和高血压）似乎易发生 PA；抗血栓治疗也可能很重要。
