蛛网膜下腔出血后的下丘脑 - 垂体 - 肾上腺功能
Hypothalamic-pituitary-adrenal function after subarachnoid haemorrhage.
作者信息
Jenkins J S, Buckell M, Carter A B, Westlake S
出版信息
Br Med J. 1969 Dec 20;4(5685):707-9. doi: 10.1136/bmj.4.5685.707.
Abstract
In 18 patients with a ruptured aneurysm of the anterior communicating artery on the circle of Willis hypothalamuc-pituitary-adrenal function has been assessed by the diurnal variation in plasma cortisol levels and by the response to metyrapone, dexamethasone, and pyrogen. Eleven patients had an abnormal diurnal variation, seven had an abnormal response to metyrapone, and eight had an abnormal response to dexamethasone. All who were given pyrogen reacted normally to this stress. Two patients who died had lesions in the anterior hypothalamus, and it is suggested that this localization of lesions was responsible for the pattern of pituitary-adrenal dysfunction which was observed. An improvement in function was seen in many patients after an interval of a month.
摘要
对18例 Willis 环前交通动脉瘤破裂患者，通过血浆皮质醇水平的昼夜变化以及对甲吡酮、地塞米松和热原的反应来评估下丘脑 - 垂体 - 肾上腺功能。11例患者昼夜变化异常，7例对甲吡酮反应异常，8例对地塞米松反应异常。所有接受热原注射的患者对这种应激反应正常。两名死亡患者的下丘脑前部有病变，提示病变的这种定位是观察到的垂体 - 肾上腺功能障碍模式的原因。许多患者在一个月的间隔后功能有所改善。
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