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原发性空蝶鞍的临床特征分析

Analysis of clinical features of primary empty sella.

作者信息

Lu Mengyu, Ye Jianzhen, Gao Feng

机构信息

Department of Endocrinology, Wuhan Fourth Hospital, 430000 Wuhan, China.

Department of Endocrinology, Huangzhou District People's Hospital, Huanggang, 438000 Hubei, China.

出版信息

Ann Endocrinol (Paris). 2023 Apr;84(2):249-253. doi: 10.1016/j.ando.2023.01.003. Epub 2023 Jan 12.

Abstract

OBJECTIVE

A retrospective analysis of clinical data of 60 patients with primary empty sella (PES) was conducted to further improve the understanding of the disease.

METHODS

The clinical data of 60 patients diagnosed with PES admitted to the Department of Endocrinology of Wuhan Union Hospital for different reasons from January 2000 to September 2018 were analyzed.

RESULTS

The 60 cases comprised 22 (36.67%) male and 38 (63.33%) female patients, for a male-to-female ratio of 1:1.73. There was predominance of 50-59 year-olds and women with multiple pregnancies. Of the 60 patients, 41.67% showed fatigue, 26.67% dizziness and headache, 21.67% nausea and vomiting, 18.33% anorexia, and 6.67% visual impairment and other symptoms. Twenty-seven patients (45.0%) had normal pituitary function, and 33 (55.0%) had hypopituitarism. Complete PES was more prone to result in hypopituitarism than partial PES. Men with PES were more likely to have hypopituitarism than women.

CONCLUSION

The incidence of PES was significantly higher in women than in men; PES was common in middle-aged and older women with multiple pregnancies. Symptoms were diverse and clinical manifestations may lack specificity compared to other diseases and need to be differentiated. About half of PES patients may develop hypopituitarism. Therefore, for patients with empty sella detected on magnetic resonance imaging (MRI) with or without clinical symptoms, the pituitary function should be thoroughly and promptly evaluated.

摘要

目的

对60例原发性空蝶鞍(PES)患者的临床资料进行回顾性分析,以进一步提高对该疾病的认识。

方法

分析2000年1月至2018年9月因不同原因入住武汉协和医院内分泌科的60例诊断为PES患者的临床资料。

结果

60例患者中男性22例(36.67%),女性38例(63.33%),男女比例为1:1.73。以50 - 59岁及多孕女性为主。60例患者中,41.67%表现为乏力,26.67%有头晕头痛,21.67%有恶心呕吐,18.33%有食欲减退,6.67%有视力障碍等症状。27例(45.0%)垂体功能正常,33例(55.0%)有垂体功能减退。完全性PES比部分性PES更易导致垂体功能减退。男性PES患者比女性更易发生垂体功能减退。

结论

PES的发病率女性显著高于男性;PES在多孕的中老年女性中常见。症状多样,与其他疾病相比临床表现可能缺乏特异性,需要鉴别。约一半的PES患者可能发生垂体功能减退。因此,对于磁共振成像(MRI)检查发现有空蝶鞍且有或无临床症状的患者,应全面、及时评估垂体功能。

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