230例中枢性尿崩症患者病因分布及临床特点分析  

Clinical characteristics of central diabetes insipidus： a retrospective analysis of 230 cases

作　　者：张吉平[2] 郭清华[1] 母义明[1] 吕朝晖[1] 谷伟军[1] 杨国庆[1] 杜锦[1] 巴建明[1] 陆菊明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853 [2]江苏省连云港市第一人民医院内分泌科,222000

出　　处：《中华内科杂志》2018年第3期201-205,共5页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金（81270866、81570705）;海南省重大专项（ZDKJ2016008）;海南省自然科学基金（20168353）;海南省卫生和计划生育委员会项目（15A200071）;海南省社会发展重点研发项目（ZDFY2016132）;海南省医学科研课题（琼卫2014资助-098号）;解放军总医院临床扶持基金（2015FC-TSYS-2025）;解放军总医院科技创新苗圃基金（16KMM43）;三亚市医疗卫生科技创新项目（2016YW31、2017YW16）

摘　　要：目的分析中枢性尿崩症的病因构成及临床特点。方法收集2008年6月至2014年12月解放军总医院内分泌科收治的230例中枢性尿崩症患者临床资料，回顾性分析其病因、临床特点、不同病因垂体前叶功能受影响的情况。结果导致中枢性尿崩症前3位的疾病是特发性中枢性尿崩症、淋巴细胞性垂体炎和生殖细胞瘤，其中特发性中枢性尿崩症占全部中枢性尿崩症的34．78％；从发病年龄看，生殖细胞瘤发病年龄较轻[（19．2±10．2）岁]；在性别构成比方面，生殖细胞瘤男性多于女性，淋巴细胞性垂体炎女性多于男性；垂体前叶功能异常发生率由高至低依次为生长激素轴、性激素轴、肾上腺轴以及甲状腺轴；生殖细胞瘤患者在甲状腺轴、肾上腺轴功能异常发生率均明显高于特发性中枢性尿崩症及淋巴细胞性垂体炎患者。结论最常见导致中枢性尿崩症的病因为特发性、淋巴细胞性垂体炎和生殖细胞瘤，发病年龄、性别、垂体前叶受累及的程度在不同病因间具有差异。Objective To evaluate the clinical characteristics and etiologies of central diabetes insipidus （CDI）. Methods The clinical data of 230 patients with CDI in the Department of Endocrinology of Chinese PLA General Hospital from 2008 June to 2014 December were collected and analyzed retrospectively. Results The three most common causes of CDI were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. Among all the CDI, the idiopathic CDI accounted for 37.48%. There were significant differences in age onset and gender distribution among the different causes of CDI. The patients with intracranial germ cell tumors [age of onset（19.2＋10.2） years] were younger than the other types of CDI. Germ cell tumors patients were more common in male, and lymphocytic hypophysitis patients were more common in female. The most frequent abnormality of anterior pituitary in patients with CDI was growth hormone deficiency, followed by hypogonadism, adrenal insufficiency and hypothyroidism. The dysfunction of thyroid axis and adrenal axis in patients with germ cell tumor was more common than those in patients with idiopathic and lymphocytic hypophysitis. Conclusions The most common causes of central diabetes insipidus were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. There were differences in age of onset, gender distribution and abnormal production of anterior pituitary hormones amon- all causes of CDI patients.

关 键 词：尿崩症 中枢性 病因 垂体 前叶 

分 类 号：R584.3[医药卫生—内分泌]