颅脑损伤后继发肾上腺皮质功能不全的临床研究  

Adrenal insufficiency after traumatic brain injury

作　　者：凌晓东[1] 陈高[1] 李珉[1] 

机构地区：[1]浙江大学医学院附属第二医院神经外科,杭州310009

出　　处：《浙江医学》2010年第9期1344-1345,1348,共3页Zhejiang Medical Journal

摘　　要：目的 研究各型颅脑损伤后肾上腺皮质功能不全（Al）发生情况.方法 分析48例颅脑损伤患者受伤后72h早晨8时的基础皮质醇水平;同时应用小剂量ACTH刺激实验,检测刺激后30、60min的皮质醇水平,确定Al发生情况.结果 轻型、中型、重型颅脑损伤的皮质醇浓度分别为（660.57 ±233.66）、（675.46±326.1）、1625.05±316.6）nmol/L.3组间的差异无统计学意义（P〉0.05）.Al发生率分别为0%（0/8）、17.6%（3/17）、43.5%（10/23）,3组间的差异有统计学意义（P〈0.05）.结论 颅脑损伤后基础皮质醇水平不能反应肾上腺皮质功能不全;Al在重型颅脑损伤中发生率较高.Objective To evaluate the occurance of adrenal insufficiency （AI） after traumatic brain injury （TBI）. Methods ACTH stimulation test was performed in 48 TBI patients 72 h after injury, the baseline eortisol levels and cortisol levels at 30 and 60 rain of low-dose cortisol administration were measured. Results The cortisol levels in patients with mild, medium, severe TBI were 660.57±233.66, 675.46± 326.1 and 625.05 ± 316.6 nmol/I （P 〉0.05 ）. The AI incidence rates were 0.0% （0/8）, 17.6% （3/17） and 43.5%（10/23）, respectively （P 〈0.05）. Conclusion The incidence of adrenal insufficiency in severe traumatic brain injury is higher than mild and medium injury, but the baseline cortisol levels are not related to the incidence of adrenal insufficiency.

关 键 词：颅脑损伤 皮质醇 肾上腺皮质功能不全 

分 类 号：R586[医药卫生—内分泌]