重症创伤性颅脑损伤后血清垂体前叶激素的变化及相关因素  

Changes of serum anterior pituitary hormones and related factors after severe traumatic brain injury

作　　者：李敏 陈贵平 田志华 申建波 崔杰 段海锋 张浩 茹小红 LI Min;CHEN Gui-ping;TIAN Zhi-hua;SHEN Jian-bo;CUI Jie;DUAN Hai-feng;ZHANG Hao;RU Xiao-hong(Department of Neurosurgery,Jin Cheng People's Hospital,Jincheng,Shanxi 048000,China)

机构地区：[1]晋城市人民医院神经外科,山西晋城048000

出　　处：《中国临床研究》2022年第2期182-185,共4页Chinese Journal of Clinical Research

基　　金：山西省卫生计生委科研课题(2019151)。

摘　　要：目的分析重症创伤性颅脑损伤后血清垂体前叶激素的变化及相关因素。方法回顾性分析2018年6月至2020年6月晋城市人民医院收治的重症创伤性颅脑损伤患者109例的临床资料,在颅脑损伤后1~3 d采取静脉血检测血清垂体前叶激素水平,按照是否出现血清垂体前叶激素分泌异常分为正常组(n=60)与异常组(n=49),对影响血清垂体前叶激素分泌异常的高危因素进行探讨。结果与正常组相比,异常组C反应蛋白水平以及颅底骨折、GCS评分3~8分、弥漫性轴索损伤、脑疝、外伤性蛛网膜下腔出血发生率均较高,差异有统计学意义(P<0.05,P<0.01)。多因素Logistic回归分析可见,GCS评分3~8分以及存在颅底骨折、弥漫性轴索损伤、脑疝和蛛网膜下腔出血均为影响血清垂体前叶激素分泌异常的独立危险因素(P<0.05)。结论重症创伤性颅脑损伤急性期存在较高的血清垂体前叶激素分泌异常的发生风险,其中能够对血清垂体前叶激素分泌异常带来影响的危险因素包括GCS评分3~8分以及存在颅底骨折、弥漫性轴索损伤、脑疝和蛛网膜下腔出血等,监测血清垂体前叶激素分泌情况,对临床病情的评估有重要意义。Objective To explore the changes in serum anterior pituitary hormones and the related factors of patients with severe traumatic brain injury.Methods The clinical data of 109 patients with severe traumatic brain injury treated in the Jin Cheng People's Hospital from June 2018 to June 2020 were retrospectively analyzed.The patients were divided into normal group(n=60)and abnormal group(n=49)according to serum levels of anterior pituitary hormones detected 1 to 3 days after craniocerebral injury.The high-risk factors of the abnormal secretion of serum anterior pituitary hormones was explored.Results Compared with those in normal group,the level of C-reactive protein and the incidences of skull base fracture,Glasgow coma scale score(GCS)of 3-8,diffuse axonal injury,cerebral hernia and traumatic subarachnoid hemorrhage significantly increased in abnormal group(P<0.05,P<0.01).Multivariate Logistic regression analysis showed that skull base fracture,GCS score of 3-8,diffuse axonal injury,cerebral hernia and subarachnoid hemorrhage were the independent risk factors for abnormal secretion of serum anterior pituitary hormones(P<0.05).Conclusions Severe traumatic brain injury has a higher risk of abnormal secretion of serum anterior pituitary hormones.The risk factors that can affect the abnormal secretion of serum anterior pituitary hormones include GCS score of 3-8 and existence for skull base fractures,diffuse axonal injuries,brain herniation,and subarachnoid hemorrhage.Monitoring the serum levels of anterior pituitary hormones is of great significance to the evaluation of disease.

关 键 词：颅脑损伤 重症 创伤性 垂体前叶激素 格拉斯哥昏迷指数评分 

分 类 号：R651.15[医药卫生—外科学]