Gao T S, Shi Y F, Gao S M
Department of endocrinology, Peking Union Medical College Hospital, Beijing.
Zhonghua Nei Ke Za Zhi. 1990 Apr;29(4):205-9, 252.
The type and percentage of multiple pituitary hormone deficiency (MPHD) were studied in 42 patients with idiopathic growth hormone deficiency (IGHD). It was found that the development of secondary sexual characteristics was poor or absent in 39 patients (93%) with gonadotropin deficiency (GnD). Mean serum testosterone (T), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in the 39 patients were significantly less than those of normal adult males (P less than 0.01). Mean testicular volume in 36 patients with GnD was significantly less than that in 3 with normal T level. We also found that 24-hour urinary free cortisol level (24 hour UFC) was low in 24 (57.1%) of 42 patients, but it is important that none had obvious symptoms of hypoadrenocorticism such as hypoglycemia, hypotension etc and received adrenal-corticosteroid treatment. 22 (52.4%) of the 42 patients suffered from hypothyroidism, with serum thyroxine (T4) level lower than normal but thyrotrophin (TSH) within normal range. 6 patients with hypothyroidism had moderate symptoms such as cold intolerance, constipation, rough and dry skin, slowing down both mentally and physically. 17 patients have treated with thyroxine. From the results mentioned above, 14 of the 41 patients with MPHD had pan-pituitary hormones (LH, FSH, TSH, ACTH) deficiency, only one had isolated growth hormone deficiency. Among all the patients, 23 underwent breech delivery and 11 patients had birth asphyxia. We therefore conclude that: (1) most of the IGHD cases are complicated with other pituitary hormone deficiency; (2) most of the IGHD cases have with MPHD; (3) Breech delivery and birth asphyxia were important etiological factors of IGHD.
对42例特发性生长激素缺乏症（IGHD）患者的多种垂体激素缺乏（MPHD）类型及百分比进行了研究。结果发现，39例促性腺激素缺乏（GnD）患者（93%）的第二性征发育不良或未发育。这39例患者的平均血清睾酮（T）、黄体生成素（LH）和卵泡刺激素（FSH）水平显著低于正常成年男性（P<0.01）。36例GnD患者的平均睾丸体积显著小于3例T水平正常者。我们还发现，42例患者中有24例（57.1%）的24小时尿游离皮质醇水平（24小时UFC）较低，但重要的是，无一例有低血糖、低血压等明显的肾上腺皮质功能减退症状，也未接受肾上腺皮质激素治疗。42例患者中有22例（52.4%）患有甲状腺功能减退症，血清甲状腺素（T4）水平低于正常，但促甲状腺激素（TSH）在正常范围内。6例甲状腺功能减退症患者有中度症状，如不耐寒、便秘、皮肤粗糙干燥、身心反应迟缓。17例患者接受了甲状腺素治疗。根据上述结果，41例MPHD患者中有14例存在全垂体激素（LH、FSH、TSH、ACTH）缺乏，仅1例为单纯生长激素缺乏。所有患者中，23例为臀位分娩，11例有出生时窒息史。因此，我们得出结论：（1）大多数IGHD病例合并有其他垂体激素缺乏；（2）大多数IGHD病例合并MPHD；（3）臀位分娩和出生时窒息是IGHD的重要病因。
