Nose O, Iida Y, Kai H, Harada T, Okada S, Yabuuchi H, Miyai K
Eur J Pediatr. 1978 Aug 17;129(1):1-9. doi: 10.1007/BF00441368.
Somatotropic, thyrotropic, gonadotropic and corticotropic functions in 10 patients with idiopathic hypopituitary dwarfism (IH) were investigated. The patients were divided into two groups: Group I (5 patients) had normal plasma T4 levels, and Group II (5 patients) had T4 levels of less than 4.6 microgram/dl. In Group I three cases had isolated growth hormone (GH) deficiency and two cases had GH and gonadotropin (Gn) deficiencies; in Group II the 5 cases showed multiple anterior pituitary hormone deficiencies. In Group II, the plasma thyroid stimulating hormone (TSH) was 4.1-9.4 muU/ml and the response to thyrotropin releasing hormone (TRH) was greatly delayed and prolonged, with a maximum after 120 min instead of 15 min. The basal prolactin (PRL) level in Group II was 12-31 ng/ml, which was significantly higher than normal (P less than 0.001). In 4 cases in Group II, the plasma cortisol level increased 120 min after the infusion of lysine-vasopressin, whereas oral administration of metyrapone and hypoglycemia induced by insulin did not increase the plasma cortisol levels. From these findings it is concluded that hypothalamic lesions caused the pituitary hormone deficiencies in 4 Group II cases, and Group I may tentatively be differentiated from Group II by T4 determinations.
对10例特发性垂体性侏儒症（IH）患者的生长激素、促甲状腺激素、促性腺激素和促肾上腺皮质激素功能进行了研究。患者分为两组：第一组（5例）血浆T4水平正常，第二组（5例）T4水平低于4.6微克/分升。第一组中3例为单纯生长激素（GH）缺乏，2例为GH和促性腺激素（Gn）缺乏；第二组5例均表现为多发性垂体前叶激素缺乏。第二组中，血浆促甲状腺激素（TSH）为4.1 - 9.4微单位/毫升，对促甲状腺激素释放激素（TRH）的反应明显延迟且延长，高峰出现在120分钟而非15分钟。第二组基础催乳素（PRL）水平为12 - 31纳克/毫升，显著高于正常水平（P < 0.001）。第二组4例患者在输注赖氨酸加压素120分钟后血浆皮质醇水平升高，而口服甲吡酮和胰岛素诱导的低血糖均未使血浆皮质醇水平升高。从这些发现得出结论，第二组中有4例患者的垂体激素缺乏是由下丘脑病变引起的，且通过T4测定可初步将第一组与第二组区分开来。
