Yeh Chih-Fan, Shih Shyang-Rong, Lin Mao-Shin, Li Hung-Yuan, Chen Yin-Hsien, Huang Ching-Chang, Hung Chi-Sheng, Kao Hsien-Li
Division of Cardiology.
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital.
Acta Cardiol Sin. 2018 Nov;34(6):472-480. doi: 10.6515/ACS.201811_34(6).20180818A.
Brain ischemia may affect hypothalamic-pituitary axis function, which may influence the outcomes of patients with internal carotid artery (ICA) stenosis/occlusion. The objective of this study was to determine the influence of successful carotid revascularization on pituitary function in patients with severe ICA stenosis/occlusion.
This study was conducted from April 2009 to December 2014. Patients receiving successful endovascular interventions for severe ICA stenosis/occlusion were enrolled. The patients were divided into 2 groups: group 1 with abnormal ipsilateral cerebral perfusion, and group 2 without. Endocrine profiles were measured before and > 1 year after the procedure. Computed tomography perfusion studies were used to assess brain perfusion.
Thirty-seven patients received successful interventions. Three patients were excluded due to re-stenosis before 1 year. There were 23 and 11 patients in group 1 and 2, with mean ages of 68 and 69 years, respectively. In the female patients, follicular stimulating hormone (FSH) and luteinizing hormone (LH) increased significantly (p = 0.043) after the interventions with a stable estradiol level in group 1. In contrast, FSH, LH and estradiol showed a decreasing trend in group 2. In the male patients, FSH and LH increased significantly (p < 0.01) after the interventions with a stable testosterone level in group 1, while testosterone showed a decreasing trend in group 2. Thyroid stimulating hormone increased significantly in the women in both groups, and in the men in group 1.
Successful revascularization for severe ICA stenosis/occlusion may improve their pituitary function, especially FSH and LH levels.
脑缺血可能影响下丘脑 - 垂体轴功能，这可能会影响颈内动脉（ICA）狭窄/闭塞患者的预后。本研究的目的是确定成功的颈动脉血运重建对严重ICA狭窄/闭塞患者垂体功能的影响。
本研究于2009年4月至2014年12月进行。纳入接受严重ICA狭窄/闭塞成功血管内介入治疗的患者。患者分为两组：第1组同侧脑灌注异常，第2组无异常。在手术前及术后1年以上测量内分泌指标。采用计算机断层扫描灌注研究评估脑灌注。
37例患者接受了成功的介入治疗。3例患者因术后1年内再狭窄被排除。第1组和第2组分别有23例和11例患者，平均年龄分别为68岁和69岁。在女性患者中，第1组干预后促卵泡生成素（FSH）和促黄体生成素（LH）显著升高（p = 0.043），雌二醇水平稳定。相比之下，第2组FSH、LH和雌二醇呈下降趋势。在男性患者中，第1组干预后FSH和LH显著升高（p < 0.01），睾酮水平稳定，而第2组睾酮呈下降趋势。两组女性及第1组男性的促甲状腺激素均显著升高。
成功的严重ICA狭窄/闭塞血运重建可能改善其垂体功能，尤其是FSH和LH水平。
