Yokota H, Kobayashi S, Yajima K, Nakazawa S, Yano M, Yamamoto Y, Otsuka T
No Shinkei Geka. 1985 Sep;13(9):973-80.
Measurement of the serum level of anterior pituitary hormones (GH, TSH, LH and FSH) and the response of these hormones to their releasing hormones were made in 45 uncomplicated head injury patients within 24 hours after injury. We classified these 45 patients into three groups according to the Glasgow Outcome Scale of six months after head injury, such as good outcome group (GR or MD), poor outcome group (SD or PVS) and dead group. The serum level of the anterior pituitary hormones in dead group were higher than those in the good or poor outcome group, especially the level of GH. The serum level of GH was 14.7 +/- 3.0 ng/ml in the dead group, whereas 5.8 +/- 0.9 ng/ml in the good outcome group and 4.0 +/- 2.1 ng/ml in the poor outcome group. The response of TSH, LH or FSH to the administration of TRH or LH-RH were depressed in the dead group. On the other hand, there were normal response of TSH, LH or FSH following administration of TRH or LH-RH in the other two survival groups. These findings suggested that the measurement of the anterior pituitary hormones and the response of these hormones to their releasing hormones were useful to evaluate the severity of head injury.
在45例单纯性颅脑损伤患者伤后24小时内测定了血清垂体前叶激素(生长激素、促甲状腺激素、黄体生成素和卵泡刺激素)水平,并检测了这些激素对其释放激素的反应。我们根据颅脑损伤后6个月的格拉斯哥预后评分将这45例患者分为三组,即预后良好组(恢复良好或中度残疾)、预后不良组(重度残疾或植物状态)和死亡组。死亡组患者的垂体前叶激素血清水平高于预后良好组或预后不良组,尤其是生长激素水平。死亡组生长激素血清水平为14.7±3.0 ng/ml,而预后良好组为5.8±0.9 ng/ml,预后不良组为4.0±2.1 ng/ml。死亡组促甲状腺激素、黄体生成素或卵泡刺激素对促甲状腺激素释放激素或促黄体生成素释放激素给药的反应降低。另一方面,在另外两个存活组中,促甲状腺激素、黄体生成素或卵泡刺激素在给予促甲状腺激素释放激素或促黄体生成素释放激素后有正常反应。这些发现提示,测定垂体前叶激素及其对释放激素的反应有助于评估颅脑损伤的严重程度。