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垂体功能减退症的诊断与治疗。

Diagnosis and Treatment of Hypopituitarism.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Endocrinol Metab (Seoul). 2015 Dec;30(4):443-55. doi: 10.3803/EnM.2015.30.4.443.

Abstract

Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency. Dynamic stimulation tests are indicated in equivocal basal hormone levels and GH/ACTH deficiency. Knowledge of the use and limitations of these stimulation tests is mandatory for proper interpretation. It is necessary for physicians to inform their patients that they may require lifetime treatment. Hormone replacement therapy should be individualized according to the specific needs of each patient, taking into account possible interactions. Long-term endocrinological follow-up of hypopituitary patients is important to monitor hormonal replacement regimes and avoid under- or overtreatment.

摘要

垂体功能减退症是一种由多种病因引起的慢性内分泌疾病。垂体功能减退症的临床表现多种多样,常起病隐匿,取决于激素缺乏的程度和严重程度。然而,它与死亡率和发病率的增加有关。因此,早期诊断和及时治疗是必要的。除了生长激素(GH)和促肾上腺皮质激素(ACTH)缺乏症外,通过测量基础垂体和靶激素水平可以很容易地诊断垂体功能减退症。在基础激素水平不确定和 GH/ACTH 缺乏时,需要进行动态刺激试验。了解这些刺激试验的用途和局限性对于正确解释是必要的。医生有必要告知患者,他们可能需要终身治疗。根据每个患者的具体需求,应个体化进行激素替代治疗,考虑到可能的相互作用。对垂体功能减退症患者进行长期的内分泌随访,监测激素替代治疗方案并避免治疗不足或过度治疗是很重要的。

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