垂体瘤术后患者腺垂体功能减退与激素替代治疗  

Hypopituitarisim and hormone replacement therapy after operation of hypophysoma

作　　者：范慧洁[1] 杨雪[1] 崔国敏[1] 于江红[1] 董其娟 

机构地区：[1]郑州人民医院内分泌科,450012

出　　处：《中华实用诊断与治疗杂志》2014年第9期876-878,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨垂体瘤术后患者腺垂体功能减退以及激素替代治疗情况。方法测定68例垂体瘤术后患者腺垂体功能,统计腺垂体功能减退发生率。将31例甲状腺功能减退和/或肾上腺皮质功能减退患者分为观察组16例(未行激素替代治疗)和对照组15例(已行激素替代治疗),对照组维持原替代治疗方案,观察组给予左甲状腺素片和/或泼尼松口服,分别于确诊时及用药后1、2、3、6个月行甲状腺功能和/或皮质醇、促肾上腺皮质激素水平检测并进行比较。结果本组发生腺垂体功能减退44例,发生率为64.7%;观察组确诊时血清游离三碘甲状腺原氨酸、游离甲状腺素及皮质醇((3.77±1.08)pmol/L、(6.29±1.92)pmol/L、(3.33±2.13)μg/dL)低于对照组((4.36±1.10)pmol/L、(8.94±2.89)pmol/L、(5.58±2.76)μg/dL)(P<0.05),各指标治疗后3个月((4.51±1.23)pmol/L、(9.17±2.35)pmol/L、(5.68±1.96)μg/dL)、6个月((4.62±1.41)pmol/L、(9.22±2.63)pmol/L、(5.59±1.82)μg/dL)较确诊时明显提高(P<0.05),对照组治疗后1、2、3、6个月相关激素水平与确诊时比较差异无统计学意义(P>0.05)。结论垂体瘤术后易发生腺垂体功能减退,需及时行激素替代治疗。Objective To investigate hypopituitarisim and hormone replacement therapy after operation of hypophysoma. Methods The adenohypophysis function was detected in 68 patients with pituitary adenoma after surgery to calculate the incidence of hypopituitarism. Thirty-one patients with hypothyroidism and/or hypoadrenalism were divided into observation group （n= 16） receiving no replacement therapy and control group （n= 15） receiving hormone replacement therapy. Control group maintained the original replacement therapy. Observation group was treated with levothyroxine and/or oral prednisone respectively. The levels of free triiodothyronine （FT3）, free thyroxine （FT4 ） , thyroid stimulating hormone and adrenocorticotropic hormone were detected at the time of diagnosis and in 1, 2, 3 and 6 months after treatment. Results Hypopituitarism occurred in 44 patients （64.7%）. The levels of FTa, FT4 and cortisol were lower in observation group （ （3.77± 1.08 ） pmol/L, （ 6. 29 ± 1. 92 ） pmol/L, （ 3. 33 ± 2. 13 ）μg/dL） than those in control group （（4.36±1.10） pmol/L,（8. 94±2.89） pmol/L, （5. 58±2.76） μg/dL） at diagnosis （P〈0.05）, were significantly higher after 3 months （（4. 51±1.23） pmol/L, （9.17±2.35） pmol/L, （5. 6821.96） μg/dL） and 6 months （（4. 62±1.41） pmol/L, （9. 22± 2. 63）pmol/L, （5. 59± 1. 82）μg/dL） in observation group （P〈0.05）, and showed no significance differences in 1, 2, 3 and 6 months in comparison with those at diagnosis （P〉0.05）. Conclusion The patients are prone to hypopituitarism after operation of hypophysoma, and need to perform hormone replacement therapy in time.

关 键 词：腺垂体功能减退 激素替代治疗 

分 类 号：R736.4[医药卫生—肿瘤]