缺血性脑卒中后垂体功能和 IGF-I 水平。

Pituitary function and IGF-I levels following ischemic stroke.

机构信息

Department of Internal Medicine 1, Division of Endocrinology, Diabetes and Metabolism, Stroke Unit, J.W. Goethe University, Frankfurt/M., Germany.

出版信息

Cerebrovasc Dis. 2011;31(2):163-9. doi: 10.1159/000321738. Epub 2010 Dec 4.

DOI:10.1159/000321738

PMID:21135552

Abstract

BACKGROUND

Pituitary dysfunction is a known complication of traumatic brain injury and subarachnoidal hemorrhage but there are few data about pituitary dysfunction as a complication of ischemic stroke.

METHODS

We prospectively studied patients 66-274 days after an ischemic stroke, evaluating the prevalence of pituitary dysfunction (by combined releasing hormone testing: GHRH, CRH), stroke severity, outcome and incidence of anxiety and depression.

RESULTS

Thirty-two patients (82%) presented with some degree of pituitary dysfunction with predominantly impaired growth hormone response (79.5%) and secondary adrenal failure (14.6%). Abnormal anxiety and/or depression was found in 28.3 and 32.7% of the patients. NIHSS (National Institute of Health Stroke Scale) varied between 1 and 15. Improvement in neurological deficit (ΔNIHSS) correlated significantly with NIHSS at baseline (p < 0.001) but not with pituitary function.

CONCLUSIONS

Patients with ischemic stroke may suffer from pituitary dysfunction with predominantly impaired growth hormone response and secondary adrenal failure. We suggest that patients who suffer from stroke should undergo pituitary testing.

摘要

背景

脑垂体功能障碍是颅脑损伤和蛛网膜下腔出血的已知并发症，但关于脑垂体功能障碍作为缺血性中风并发症的数据很少。

方法

我们前瞻性研究了缺血性中风后 66-274 天的患者，评估了垂体功能障碍（通过联合释放激素试验：GHRH、CRH）的患病率、中风严重程度、结果以及焦虑和抑郁的发生率。

结果

32 名患者（82%）存在某种程度的垂体功能障碍，主要表现为生长激素反应受损（79.5%）和继发性肾上腺功能衰竭（14.6%）。28.3%和 32.7%的患者出现异常焦虑和/或抑郁。NIHSS（国立卫生研究院卒中量表）在 1 至 15 之间变化。神经功能缺损的改善（ΔNIHSS）与基线时的 NIHSS 显著相关（p < 0.001），但与垂体功能无关。