Wildburger R, Zarkovic N, Tonkovic G, Skoric T, Frech S, Hartleb M, Loncaric I, Zarkovic K
University Clinic of Traumatology, Graz, Austria.
J Endocrinol Invest. 1998 Feb;21(2):78-86. doi: 10.1007/BF03350319.
Traumatic brain injury (TBI) combined with fractures of long bones or large joints is often associated with enhanced osteogenesis (early fracture healing accompanied by hypertrophic callus formation and/or heterotopic ossifications). Humoral factors that cause enhanced osteogenesis in patients with TBI are not yet identified. The aim of this study was to reveal if post-traumatic change(s) of hormone levels in patients with TBI and bone fractures could be associated with the phenomenon of enhanced osteogenesis. The blood values of adrenocorticotropic hormone (ACTH), cortisol, growth hormone (GH), parathyroid hormone (PTH) and prolactin (PRL) were studied weekly over a period of three months after injury in patients with bone fractures only, those with TBI only or combined bone fractures and TBI (patients exerting enhanced osteogenesis). Stress-hormones, ACTH and cortisol, or the hormones related to the bone growth (GH and PTH) did not show any particular post-traumatic changes in the blood of patients with combined injury that could be associated with the enhanced osteogenesis. On the other hand, patients with combined bone fractures and TBI accompanied by enhanced osteogenesis had significantly elevated PRL levels in blood during the 5th week of the post-traumatic period. Thus, the maximal PRL values were measured at the time when in this group of patients fractures were in consolidation and hypertrophic callus or heterotopic ossifications were developing (as verified by x-ray imaging). Hence, PRL does not only influence physiology of the bone metabolism but also seems to be one of the humoral factors involved in the phenomenon of enhanced osteogenesis in patients with TBI.
创伤性脑损伤（TBI）合并长骨或大关节骨折常伴有骨生成增强（早期骨折愈合伴有肥厚性骨痂形成和/或异位骨化）。导致TBI患者骨生成增强的体液因子尚未明确。本研究的目的是揭示TBI和骨折患者创伤后激素水平的变化是否与骨生成增强现象有关。在仅患有骨折、仅患有TBI或合并骨折与TBI（骨生成增强的患者）的患者受伤后的三个月内，每周研究促肾上腺皮质激素（ACTH）、皮质醇、生长激素（GH）、甲状旁腺激素（PTH）和催乳素（PRL）的血液值。应激激素ACTH和皮质醇，或与骨生长相关的激素（GH和PTH）在合并损伤患者的血液中未显示出任何与骨生成增强相关的特殊创伤后变化。另一方面，合并骨折与TBI且伴有骨生成增强的患者在创伤后第5周时血液中的PRL水平显著升高。因此，在该组患者骨折处于愈合期且正在形成肥厚性骨痂或异位骨化时（经X线成像证实）测量到了PRL的最大值。因此，PRL不仅影响骨代谢生理，而且似乎是参与TBI患者骨生成增强现象的体液因子之一。
