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创伤性脑损伤三个月或更长时间后的垂体功能障碍模式

Patterns of pituitary dysfunction three months or more after traumatic brain injury.

作者信息

Yaseen Nassar Taha, Al-Khaqani Fateh A, Mansour Abbas Ali

机构信息

Department of Medicine, Basrah College of Medicine, Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah, Iraq.

出版信息

Avicenna J Med. 2018 Oct-Dec;8(4):125-132. doi: 10.4103/ajm.AJM_2_18.

Abstract

PURPOSE

Chronic posttraumatic brain injury (TBI) pituitary dysfunction is not a newly discovered subject, it has been reported more frequently, probably due to increasing chances of exposure to its causes, mainly the road traffic accidents, sport-related injuries, falls, and injuries during wars. This study aims to estimate the frequency of pituitary dysfunction 3 months or more after head trauma and the patterns of hormonal deficiencies.

METHODS

A cross-sectional study was conducted between January 2016 and August 2017. Participants were patients having a history of moderate-to-severe TBI at least 3 months before enrolment. Pituitary function test was done for all patients to determine the frequency of pituitary dysfunction, the number of axes deficiencies, and which hormone is mostly affected. Statistical Package for the Social Sciences (SPSS) version 23.0 was used for univariate analysis, < 0.05 was considered statistically significant.

RESULTS

Out of the 28 patients involved in this study, 17 (61%) had pituitary dysfunction, while 11 (39%) had not. Single hormonal defect was the most prevalent abnormality in 12 (43%), and the most affected hormone was the growth hormone (GH) in 14 patients (50%), followed by gonadal axis, thyroid stimulating hormone, and finally adrenocorticotropic hormone (ACTH), 6 (21%), 3 (11%), and 1 (4%), respectively.

CONCLUSION

TBI pituitary dysfunction is more prevalent than was predicted in the population studied, single hormonal defect was found to be the most prevalent abnormality, being the GH is the most affected axis, and the ACTH seems to be the least.

摘要

目的

慢性创伤性脑损伤(TBI)后的垂体功能障碍并非新发现的课题,其报道日益增多,这可能是由于接触其病因的机会增加,主要病因包括道路交通事故、运动相关损伤、跌倒以及战争期间的损伤。本研究旨在评估头部创伤3个月或更长时间后垂体功能障碍的发生率以及激素缺乏的模式。

方法

于2016年1月至2017年8月进行了一项横断面研究。研究对象为入组前至少3个月有中度至重度TBI病史的患者。对所有患者进行垂体功能测试,以确定垂体功能障碍的发生率、轴系缺乏的数量以及受影响最严重的激素。使用社会科学统计软件包(SPSS)23.0版进行单因素分析,P<0.05被认为具有统计学意义。

结果

本研究纳入的28例患者中,17例(61%)存在垂体功能障碍,11例(39%)无垂体功能障碍。单一激素缺陷是最常见的异常情况,有12例(43%),受影响最严重的激素是生长激素(GH),有14例患者(50%),其次是性腺轴、促甲状腺激素,最后是促肾上腺皮质激素(ACTH),分别有6例(21%)、3例(11%)和1例(4%)。

结论

在所研究的人群中,TBI后的垂体功能障碍比预期更为普遍,单一激素缺陷是最常见的异常情况,其中GH轴受影响最严重,而ACTH轴似乎受影响最小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c3c/6178569/9558987b8c6f/AJM-8-125-g003.jpg

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