215例垂体腺瘤术后患者腺垂体功能评估及替代状况分析  

Outcome of postoperative hypopituitarism and hormone replacement situation in 215 patients with pituitary adenoma

作　　者：曾梅芳[1] 蒋翠萍[3] 叶红英[1] 张烁[1] 何敏[1] 杨叶虹[1] 鹿斌[1] 胡仁明[1] 李士其[2] 赵曜[2] 王镛斐[2] 李益明[1] 

机构地区：[1]复旦大学附属华山医院内分泌科,上海200040 [2]复旦大学附属华山医院神经外科,上海200040 [3]复旦大学附属华东医院内分泌代谢科

出　　处：《中华内分泌代谢杂志》2012年第7期546-550,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：国家自然科学基金项目（30900501）;教育部新教师基金（20090071120042）

摘　　要：目的了解垂体腺瘤术后患者腺垂体功能减退及其替代治疗情况，寻找与其功能减退可能相关的凶素。方法对215例就诊于华山医院内分泌科的垂体腺瘤术后患者进行垂体性腺轴、甲状腺轴、肾上腺皮质轴功能评估，收集手术病史、替代状况等资料进行统计分析。结果存在腺垂体功能减退的患者占54．0％，其中性腺、甲状腺、肾上腺皮质功能减退的比例分别为36．7％、32．6％、28．4％，相应激素替代为25．6％、84．3％、80．6％。单因素分析显示男性和肿瘤较大与腺垂体功能减退相关。结论内分泌科就诊的垂体腺瘤术后患者半数存在腺垂体功能减退，而且有相当一部分功能减退的患者未能得到恰当的替代治疗，、Objective To investigate the outcome of postoperative hypopltuitarism and hormone replacement in patients with pituitary adenoma, and to analyze the potential factors related to postoperative hypopituitarism. Methods A total of 215 postoperative patients with pituitary adenoma were analyzed. Pituitary functions（ including gonadal, thyroid, and adrenal axes）were assessed by strict criteria. Data of surgery history and hormone replacement situation were collected for statistical analysis. Results The prevalence of hypopituitarism was 54.0% , including 36.7% hypogonadism, 32.6% hypothyroidism, and 28.4% hypoadrenalism. Replacements of gonadal steroid, glucocorticoid, and thyroxine were carried out in 25.6% , 84.3% , and 80.6% of the cases, respectively. Univariate analysis showed that male sex and large tumor were related to hypopituitarism. Conclusion After pituitary adenomectomy, approximately half of the patients present anterior pituitary dysfunction, while quite a number of them have not been treated appropriately.

关 键 词：腺垂体功能减退 激素替代治疗 垂体肿瘤 术后 

分 类 号：R736.4[医药卫生—肿瘤]