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生长激素缺乏症患儿围产期不良事件与空蝶鞍的关联

Association of adverse perinatal events with an empty sella turcica in children with growth hormone deficiency.

作者信息

Surtees R, Adams J, Price D, Clayton P, Shalet S

机构信息

Department of Child Health, University of Manchester School of Medicine, UK.

出版信息

Horm Res. 1987;28(1):5-12. doi: 10.1159/000180918.

Abstract

High-resolution computed tomography (HR-CT) of the hypothalamo-pituitary region was performed in 26 consecutive children presenting with growth hormone deficiency (GHD) at one clinic. 58% had an empty sella turcica (ES) and 42% a full sella turcica (FS). There was no difference between the ES and FS groups for mean (+/- 95% confidence limits) presentation age (ES 6.7 (+/- 1.8) years, FS 5.6 (+/- 2.2) years), height standard deviation score (SDS) (ES -3.9 (+/- 0.8), FS -3.3 (+/- 0.5] nor head circumference SDS (ES -1.9 (+/- 1.1), FS -0.7 (+/- 1.1]. There were significant associations between the ES group and a history of adverse perinatal events (p less than 0.001) and multiple pituitary deficiency (p = 0.014). Growth hormone response to an acute growth hormone releasing factor test showed no association with HR-CT diagnosis. Sella turcica volumes were calculated from the HR-CT scans. All sella volumes were small; mean SDS for height was -2.6 (+/- 0.2). There was no difference in sella volume SDS between the ES and FS groups (ES -2.9 (+/- 0.3), FS -2.5 (+/- 0.4]. Adverse perinatal events may cause an ES and GHD by compromising the blood supply to the pituitary gland or infundibulum.

摘要

对某一诊所连续就诊的26例生长激素缺乏症(GHD)患儿进行了下丘脑 - 垂体区域的高分辨率计算机断层扫描(HR - CT)。58%的患儿存在空蝶鞍(ES),42%存在满蝶鞍(FS)。ES组和FS组在平均(±95%置信区间)就诊年龄(ES 6.7(±1.8)岁,FS 5.6(±2.2)岁)、身高标准差评分(SDS)(ES -3.9(±0.8),FS -3.3(±0.5))以及头围SDS(ES -1.9(±1.1),FS -0.7(±1.1))方面均无差异。ES组与围产期不良事件史(p<0.001)和多种垂体功能减退(p = 0.014)之间存在显著关联。生长激素对急性生长激素释放因子试验的反应与HR - CT诊断无关。蝶鞍体积通过HR - CT扫描计算得出。所有蝶鞍体积均较小;身高的平均SDS为 -2.6(±0.2)。ES组和FS组之间的蝶鞍体积SDS无差异(ES -2.9(±0.3),FS -2.5(±0.4))。围产期不良事件可能通过损害垂体或漏斗部的血液供应而导致空蝶鞍和生长激素缺乏症。

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