妊娠与淋巴细胞性垂体炎  

Pregnancy and lymphocytic hypophysitis

作　　者：王雅静 臧丽 魏茜 杨国庆 吕朝晖 Wang Yajing;Zang Li;Wei Qian;Yang Guoqing;Lyu Zhaohui(Department of Endocrinology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,Hainan Hospital of Chinese PLA General Hospital,Sanya 572013,China)

机构地区：[1]中国人民解放军总医院第一医学中心内分泌科,北京100853 [2]中国人民解放军总医院海南医院内分泌科,三亚572013

出　　处：《中华内分泌代谢杂志》2022年第1期83-86,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：淋巴细胞性垂体炎(lymphocytic hypophysitis,LYH)是一种较为少见的自身免疫性疾病,女性多见,且与妊娠密切相关。LYH患者的临床表现与疾病进展速度、病变范围、严重程度、疾病进展阶段有关,可表现为占位效应、部分或全垂体前叶功能减退、中枢性尿崩症等。妊娠期女性的垂体解剖结构和垂体相关激素水平发生变化,加之妊娠期影像学检查存在一定限制,使得妊娠期LYH的诊断存在较大挑战,需结合患者临床症状及生化检测综合诊断。妊娠期LYH患者如出现垂体前叶或(和)后叶功能减退,应给予相应激素进行替代治疗;同时对处于妊娠不同时期、不同临床表现患者采取不同的优化处理方案;LYH对妊娠结局及再次妊娠目前暂无不良影响报道。本文针对妊娠期LYH患者的诊断、治疗及预后等相关问题进行综述,旨在为妊娠期LYH患者的临床管理提供参考。Lymphocytic hypophysitis(LYH)is a rare autoimmune disease,which is more common in women and is closely associated with pregnancy.For patients with lymphocytic hypophysitis,the clinical manifestations mainly depend on the speed of disease progression,the extent of lesions,the severity and stage of disease,which can present as mass effect,decreased anterior pituitary hormone function,and central diabetes insipidus,etc.Due to physical changes in pituitary anatomy and hormone levels,as well as restriction of imaging examinations during pregnancy,it poses greater challenge to establish diagnosis in perinatal patients,which demands a comprehensive assessment of the patient′s clinical symptoms and biochemical tests.For treatment,patients with hypopituitarism during pregnancy should be given hormone replacement therapy.Moreover,patients need to adopt optimized tailored therapy according to gestational age and various clinical manifestations.At present,there is no report on the adverse effects of LYH on pregnancy outcome and re-pregnancy.This review discusses the diagnosis,treatment and prognosis of patients with LYH during pregnancy,and provides reference for the clinical management of this condition.

关 键 词：淋巴细胞性垂体炎 妊娠 治疗 预后 

分 类 号：R714.256[医药卫生—妇产科学]