Pituitary hormone reserve in the Laurence-Moon-Bardet-Biedl syndrome

A patient who presented with hypgonadism was found to have classical features of the Laurence-Moon-Bardet-Syndrome. He had oligospermia and low serum testosterone. Basal serum thyroid stimulating hormone (TSH), prolactin (PRL), growth hormone (GH), cortisol, luteinising hormone (LH) and follicle stimulating hormone (FSH) were normal. Stimulation with thyrotropin releasing hormone. (TRH) showed normal pituitary reserve for TSH and PRL. Adequate insulin hypoglycaemia caused a normal rise of GH and cortisol. LH and FSH showed normal peaks after luteinishing hormone releasing hormone (LHRH). These results indicate normal pituitary hormone reserve and hypogonadotrophic hypgonadism secondary to hypothalamic dysfunction.     

PRE- AND POST-OPERATIVE HYPOTHALAMIC-PITUITARY- THYROIDAL AXIS FUNCTION IN PATIENTS WITH PROLACTINOMA, GROWTH HORMONE TUMOUR AND ACTH TUMOUR

Pre- and postoperative hypothalamic-pituitary-thyroid axis function was studied in 38 patients with pituitary adenomas (PRL, GH and ACTH tumours), of whom 35 were surgically confirmed and three diagnosed by clinical signs, CT scanning and hormone assessments. About ten days after operation, the same study was repeated in 10 patients with prolactinoma and 7 with growth hormone (GH) tumour. The preoperative abnormal serum TSH response to TRH was found in 8/20 patients with prolactinoma, 9/16 with GH tumour, and 2/2 with Cushing's disease due to ACTH microadenoma. The incidence of abnormal TSH response to TRH was not significantly increased in patients with larger adenoma in either PRL or GH tumour group. In 8 cases of prolactinoma, metoclopramide (MCP, 10 mg, P.O.) test was also performed and there was a significant positive correlation between TSH responses to TRH and to MCP. Serum TT3 in the GH tumour group was within normal ranges, but significantly higher than that of the normal and prolactinoma groups. After operation, TT3 was significantly decreased as compared with that before operation and there were marked changes in TSH response to TRH. In conclusion, there were some abnormalities in TSH control in patients with non-TSH pituitary tumour, and in serum TT3 control in patients with GH tumour. The surgical treatment of pituitary adenoma can lead to transient decrease in TSH reserve and serum TT3 level probably resulting from both stress and/or destruction of thyro-trophs by the operation.     

IL-1对垂体促性腺细胞及甲状腺轴分泌功能的短期效应

本研究观察Ｗｉｓｔａｒ雄性大鼠腹腔注射ＩＬ－１后短期内（６ｈ内）血清ＬＨ、ＦＳＨ、ＰＲＬ、ＴＳＨ、Ｔ３和Ｔ４水平的变化。其结果表明，注射ＩＬ－１后血清ＬＨ和ＦＳＨ水平降低，血清ＰＲＬ水平增高；血清ＴＳＨ水平在注射后２ｈ内增高，４ｈ后恢复正常水平，而血清Ｔ３和Ｔ４水平降低。提示，ＩＬ－１在短期内可调节垂体促性腺细胞及甲状腺轴分泌功能。     

Hypothalamic dopaminergic tone and prolactin bioactivity in women with polycystic ovary syndrome

BACKGROUND: The present study was carried out to investigate the functional significance of the reduced dopaminergic tone in subjects affected with polycystic ovary syndrome (PCOS). METHODS: Our group evaluated the response of pituitary PRL, LH, FSH, and TSH to the administration of a single 10-mg oral dose of the dopamine (DA) receptor antagonist metoclopramide in lean (n = 7) and obese (n = 8) PCOS women and in 11 regularly cycling age- and weight-matched controls (six lean and five obese). In addition, circulating PRL bioactivity was evaluated by its mitogenic activity on a lymphoma cell bioassay. RESULTS: Oral administration of metoclopramide resulted in a significant increase in serum PRL in all subjects; however, the highest increments, regardless of body mass index (BMI), were observed in control women (p <0.005). Measurements of PRL mitogenic activity on the Nb2 lymphoma cell bioassay revealed a significant increase in the bioactive/immunoreactive (B/I) ratio of PRL under basal and stimulated conditions in obese PCOS subjects (p <0.05). Mean fasting glucose/insulin and glucose/insulin-AUC ratios were significantly lower (p <0.001) in obese PCOS when compared with all other groups. CONCLUSIONS: These data support the existence of low DA hypothalamic tone in PCOS women that is likely involved in the inappropriate LH and PRL secretion frequently seen in this syndrome. In addition, our results suggest changes in PRL bioactivity in obese PCOS that may play a role in the development of hyperinsulinemia; however, whether PRL has a functional significance in the development of the metabolic disturbances frequently seen in PCOS remains to be elucidated.     

垂体前叶激素水平的变化与创伤性颅脑损伤患者急性期预后的关系分析

目的:探讨垂体前叶激素水平的变化与创伤性颅脑损伤患者急性期预后的关系。方法:选择我院住院治疗的TBI患者120例作为实验组,同期选择健康体检者40例作为对照组。采用酶联免疫吸附法(ELISA)测定血清促肾上腺皮质激素(ACTH)、催乳素(PRL)、促甲状腺激素(TSH)、黄体生成素(LH)以及卵泡刺激素(FSH)的含量。观察两组实验对象血清ACTH、PRL、TSH、LH以及FSH水平。结果:实验组患者1、3、7 d血清的ACTH、PRL、LH以及FSH水平要明显高于对照组;轻型组、中型组以及重型组患者血清的ACTH、PRL、LH以及FSH水平要明显高于对照组;此外,中型组患者的血清的ACTH、PRL、LH以及FSH水平要明显高于轻型组,重型组患者的血清的ACTH、PRL、LH以及FSH水平要明显高于中型组,差异均具有统计学意义(P<0.05)。预后良好以及预后恶劣组患者血清的ACTH、PRL、LH以及FSH水平要明显高于对照组;预后恶劣组患者血清的ACTH、PRL、LH以及FSH水平要高于预后良好组,差异均具有统计学意义(P<0.05)。结论:TBI急性期患者的垂体前叶激素水平与其疾病程度以及预后关系密切,我们可以通过观察此类指标为患者治疗及预后提供理论支持。     

急性颅脑外伤垂体前叶激素的动态变化及其临床意义

对24例开颅手术的急性颅脑外伤患者的血清卵泡刺激素、黄体生成激素、促甲状腺激素、三碘甲状腺原氨酸、甲状腺素、生长激素和催乳素在伤后10d内作了动态观察。结果显示，脑外伤后垂体和甲状腺功能有明显变化，变化程度与颅脑外伤的严重程度有关。我们认为，测定颅脑外伤后垂体和甲状腺功能，并作动态观察，有助于判断脑外伤程度和估计预后。     

雌激素受体在人类多激素型垂体腺瘤中的表达

目的 研究人类多激素型垂体腺瘤中雌激素受体(ER)在分泌不同类型激素的垂体腺瘤细胞中的表达,探讨多激素型垂体腺瘤中分泌特定类型激素的垂体腺瘤细胞与ER阳性细胞的关系。方法 采用免疫组织化学双标法检测33例多激素型垂体腺瘤标本中垂体激素合并ER表达的情况,即分别检测每1例标本中PRL ER、GH ER、ACTH ER、PSH ER、FSH ER和LH ER的表达情况。结果 33例多激素型垂体腺瘤标本中有22例(66．67％)表达ER,其中：PRL ER双标染色阳性标本10例、IH ER双标染色阳性标本9例、FSH ER双标染色阳性标本7例、GH ER双标染色阳性标本2例,33例标本的ACTH ER和TSH ER的双标染色均为阴性。结论 多激素型垂体腺瘤中,分泌：PRL、IH或FSH的垂体腺瘤细胞可表达ER;分泌ACTH或TSH的垂体腺瘤细胞不表达ER;分泌GH的垂体腺瘤细胞是否表达ER可能与该垂体腺瘤是否同时分泌PRL有关。ER很可能在多激素型垂体腺瘤PRL、IH及FSH腺瘤细胞的发生、发展过程中发挥作用。     

The effect of oral cimetidine on the basal and stimulated values of prolactin, thyroid stimulating hormone, follicle stimulating hormone and luteinizing hormone.

The effect of cimetidine on the basal values of PRL, TSH, FSH and LH and on the TRH/LHRH-stimulated values of these hormones was investigated in patients with peptic ulcer. No difference was found between the values before, during or after cimetidine maintenance treatment. To evaluate whether a rise in PRL occurs during the early phase of cimetidine treatment, daily estimations were made of basal PRL values during the first week of cimetidine adminstration in volunteers. No significant difference was found. It is concluded that oral cimetidine treatment has no influence on the basal and stimulated values of PRL, TSH, FSH and LH.     

同病异证和异病同证的物质基础——肿瘤、高血压、糖尿病大鼠/小鼠神经-内分泌组织一些重要激素的转录特征

目的:揭示肿瘤、高血压、糖尿病同病异证、异病同证大鼠、小鼠神经-内分泌组织一些重要激素表达的特征。方法:采用腋下接种H22荷瘤小鼠,辨证出早期邪毒壅盛证和气虚证、中期阳气虚证和气虚证、中晚期气阴阳虚证和气虚证;采用自发性高血压大鼠和自发性糖尿病大鼠,辨证出气盛证和气虚证;分别与正常和正常气虚证大鼠、小鼠对照;采用Affymetrix外显子芯片,检测其下丘脑、垂体、甲状腺、肾上腺、性腺等组织基因表达的差异;重点观察CRH、POMC,TRH、TSH,GnRH、FSH、LH,GhRH、GH等基因表达的改变。结果:①大鼠、小鼠下丘脑TRH表达量较CRH、GnRH、GhRH大;垂体TSH、POMC、FSH、GH表达量大,并不同程度表达GnRH、GhRH、CRH;甲状腺、肾上腺、性腺等亦不同程度地表达POMC、TSH、FSH、LH、GH,小鼠尤甚,但大多没有规律;正常大鼠睾丸高表达LH。②正常大鼠、小鼠气虚证者,这些激素水平不同程度下调,唯小鼠TRH和TSHb上调。③疾病发生后,对机体危害程度较重的证候,如肿瘤的邪毒壅盛证、高血压的气盛证,其神经-内分泌有关激素的表达抑制程度略重于同期的气虚证。结论:大鼠、小鼠神经-内分泌一些重要激素调节模式略有差异。总体上,气虚证大鼠、小鼠神经-内分泌轴轻度抑制,疾病危重者抑制更显著,小鼠甲状腺轴例外。     

动脉瘤性蛛网膜下腔出血患者血清垂体激素含量变化的动态研究

目的：研究动脉瘤性蛛网膜下腔出血(SAH)患者血清促肾上腺皮质激素（ACTH）、促甲状腺激素（TSH）、卵泡刺激素（FSH）、黄体生成素（LH）、泌乳素（PRL）、生长激素（GH）浓度的动态变化规律。方法：对35例动脉瘤性SAH患者发病后1～3?d、7～9?d、13～15?d血清ACTH、TSH、FSH、LH、PRL、GH进行动态观察, 用TCD检测大脑中动脉血流速度(VMCA)。结果：动脉瘤性SAH患者血清ACTH、TSH、FSH、LH、PRL、GH发病后1～3?d、7～9?d各均值明显高于对照组（P均＜0.05）,尤以发病后7～9?d变化最明显（P＜0.01）;脑血管痉挛组较非脑血管痉挛组也有明显差异（P＜0.05）。结论：动脉瘤性SAH患者血清ACTH、TSH、FSH、LH、GH、PRL含量与病情演变、脑血管痉挛程度有关。     

刺激缰核对促性腺激素分泌及免疫功能的影响

进一步揭示缰核（Ｈｂ）与垂体内分泌及免疫器官功能的关系。采用电刺激Ｈｂ技术，观察电刺激雄性Ｗｉｓｔａｒ大鼠缰核１２ｈ后，垂体激素分泌及胸腺脾脏免疫功能的变化。结果表明，血清ＦＳＨ、ＬＨ和ＰＲＬ水平有不同程度的增高，而血清ＴＳＨ水平变化不明显；胸腺细胞自发掺入能力、胸腺和脾细胞对ＣｏｎＡ反应性及脾细胞对ＰＷＮ反应性也均不同程度地增强。上述结果提示，电刺激缰核后垂体促性腺激素分泌增高及免疫器官功能增强可能与缰核内含有多种神经递质和神经肽参与多功能的调节有关。     

癌症患者腺垂体激素分泌功能的变化研究

目的 研究癌症患者腺垂体激素分泌功能的变化。方法 用放射免疫法[fj-2008ps1]测定171例癌症患者与46例正常对照组的泌乳素(PRL)，生长激素(GH)，促卵泡生成激素(FSH)，促黄体生成激素(LH)和促甲状腺激素(TSH)的血清水平。结果 癌症患者组与正常对照组比较患者血清PRLGH，LH和FSH均增高，但TSH无显著差异；肿瘤转移组与非转移组比较则无显著差别；不同脏器恶性肿瘤间垂体激素水平也无显著差异。结论 癌症患者腺垂体激素分泌功能亢进，除TSH水平变化不显著外，其他4种垂体激素水平皆升高显著，这有助于我们了解癌症患者的机体变化。     

Hyperthyroidism due to inappropriate TSH secretion with associated hyperprolactinaemia--a case report and review of the literature.

A patient with inappropriate thyrotrophin (TSH) secretion is described. She initially presented with classical hyperthyroidism during pregnancy, responded to propylthiouracil and, subsequently, had a normal delivery. Hyperthyroidism persisted and 7.5 months later a subtotal thyroidectomy was performed. After a further 16 months, mild symptoms of hyperthyroidism recurred. She again responded to propylthiouracil, but developed galactorrhoea. At that stage, it was noted that she had persistently elevated circulating TSH in the presence of elevated T4 and T3 levels. Her symptomatology was mild, although objective indices of thyroid activity, including pulse rate, BMR, sex hormone binding globulin and cholesterol, were indicative of hyperthyroidism. CT scan and tomography of the sella were normal. She had a markedly exaggerated TSH response to thyrotrophin releasing hormone (TRH). Basal TSH and responsiveness to TRH was suppressed by high dose dexamethasone. The TSH response to TRH was partially suppressed by exogenous T3, but there was no effect on basal TSH levels. TSH also decreased slightly with L-dopa and bromocriptine. Circulating TSH rose markedly during methimazole administration. TSH alpha and beta subunits were elevated and appropriate for the high TSH. In addition, both subunits increased following TRH. The patient had basal hyperprolactinaemia with an impaired prolactin (PRL) response to TRH and metoclopramide. PRL suppressed with L-dopa and bromocriptine. The remaining anterior pituitary function was intact. Most of the laboratory findings argue against the presence of a TSH producing pituitary tumour and the most likely cause for inappropriate TSH secretion in this patient is selective resistance of the thyrotroph to thyroid hormones. A mild element of peripheral resistance might also be present. The hyperprolactinaemia could be related to lactotroph resistance to thyroid hormone. The complexities of treatment in this patient are stressed. Therapy was initially attempted with low dose dexamethasone, but this had no effect. T3 treatment produced an exacerbation of her symptomatology and did not influence basal TSH, thyroid hormones, or 131I uptake. Bromocriptine administration for 11 months partially suppressed basal TSH without influencing T3 and there was an increase in T4. Methimazole did decrease her T4 and T3, but TSH and PRL rose to even greater levels. Her hyperthyroidism was eventually controlled with an ablative dose of 131I. Thyroid hormone will be given in an attempt to suppress her TSH.     

急性脑血管病患者下丘脑一垂体功能及皮质醇变化的研究

本文用放射免疫法测定９７例急性脑血和病患者血清ＴＳＨ、ＰＲＬ、ＬＨ、ＦＳＨ等垂体激素和血浆皮质醇（血Ｆ）。结果发现：急性脑血管病嘲笑因清ＴＳＨ、ＰＲＬ和Ｆ均值明显高于正常对照组（Ｐ〈０．０１），近中线组ＰＲＬ高于 线组（Ｐ〈０．０５），死亡组ＴＳＨ、ＰＲＬ、Ｆ明显高地存活组（Ｐ〈０．０５或Ｐ〈０．０１）。提示测定ＴＳＨ、ＰＲＬ、Ｆ有助于了解急性脑血管病应激状态下机体下丘脑－垂体功能异常变化。     

慢性甲基汞中毒对大鼠垂体和睾丸内分泌功能的影响

本文采用Wistar雄性大鼠,饲喂含甲基汞饲料102天后,观察其垂体和睾丸内分泌功能变化。结果发现,饲喂甲基汞饲料大鼠血清PRL和TSH水平明显增高,而血清LH、FSH和睾丸酮(TS)水平变化不明显;但上述各指标,1ppm组较2ppm和4ppm组增高明显。提示,慢性甲基汞中毒可刺激垂体PRL和TSH合成和分泌,而对垂体-性腺轴影响不明显;另外,低剂量(1ppm组)较高剂量(2ppm和4ppm组)刺激作用明显。     

针刺对乳腺增生大鼠垂体FSH、LH和PRL的影响

目的研究针刺对外源性雌二醇(E2)诱导的MGH模型大鼠随FSH、LH和PRL的影响,进一步从垂体水平揭示针刺治疗MGH的机理。方法将SD雌性性成熟大鼠随机分为空白、模型对照和针刺治疗三组,造模成功后选取甲、乙两组穴位针刺治疗30 d,次日眼球采血2ml,检测血清FSH、LH和PRL含量。结果针刺可降低MGH大鼠血清PRL、FSH的含量(P<0.01),提高LH的浓度(P<0.01)。     

Do acute diseases transiently impair anterior pituitary function in patients over the age of 75? A longitudinal study of the TRH test and basal gonadotrophin levels.

Several studies have shown that anterior pituitary function is affected by the ageing process. Little is known, however, about the effect acute diseases have on the anterior pituitary. Should they be associated with a disturbance of anterior pituitary hormone production, they might make anterior pituitary function tests difficult to interpret when they are most needed. To test this hypothesis, we studied the thyrotrophin (TSH) releasing hormone (TRH) test and basal plasma gonadotrophins, taken as indicators of anterior pituitary function and reserve, in 74 consecutive patients (49 women) mean age 82 +/- 5.1 suffering from acute diseases soon after admission to hospital. A total of 44 (30 women) were followed up and retested after 3 disease-free months following recovery and discharge home. Seventy-one age- and sex-matched healthy controls (47 women), mean age 82 +/- 5.0 living in the community were also studied. The mean peak TSH increment after TRH (mean delta max TSH) increased from 5.7 soon after admission, to 7.7 U/l at follow-up (P = 0.01). The mean plasma LH increased from 25 to 35 U/l in women (P = 0.0004) and from 9.7 to 14 U/l in men (P = 0.03). The mean plasma FSH increased from 21 to 25 U/l in women (P = 0.04) and from 7.5 to 9.4 U/l in men (P = 0.01). Controls had greater TSH responses to TRH and higher plasma gonadotrophins levels when compared with acute patients (LH women P = 0.17, for all other tests P < 0.05). We conclude that a transient reduction of anterior pituitary function is a common occurrence in patients over the age of 75 suffering from acute diseases. This has diagnostic relevance and therapeutic implications.     

动脉瘤蛛网膜下腔出血患者血清垂体激素含量变化的研究

目的：探讨动脉瘤蛛网膜下腔出血（SAH）患者血清促甲状腺激素（TSH）、促肾上腺皮质激素（ACTH）、黄体生成素（LH）、卵泡刺激素（FSH）含量的变化及临床意义。方法：选取50例动脉瘤性SAH患者。在其发病后的1～3、7～9、14～17 d对血清TSH、ACTH、LH、FSH进行动态观察,同时用TCD检测大脑中动脉血流速度（VMCA）。结果：动脉瘤性SAH患者血清TSH、ACTH、LH、FSH发病后1～3、7～9 d各均值明显高于对照组（P〈0.05）;脑血管痉挛组与非脑血管痉挛组比较有显著性差异（P〈0.05）。结论：动脉瘤性SAH患者血清TSH、ACTH、LH、FSH含量与病情严重程度、脑血管痉挛程度相关,可作为判断预后的标准。     

急性脑血管病并发多器官功能衰竭患者腺垂体分泌功能研究

对167例急性脑血管病（ACVD）患者血清泌乳素（PRI）、生长激素（GH）促黄体生成素（LH）、促滤泡成熟激素（FSH）、促甲状腺素（TSH）及血浆促肾上腺皮质激素（ACTH）水平进行了动态观察。结果发现：ACVD患者PRL、GH、ACTH、TSH、LH、FSH水平均显著高于对照组；ACVD并发多据官功能衰竭（MOF）患者PRL、GH、FSH水平显著高于ACVD疾病各组；随ACVD病程不同，6种激素水平也相应改变，1周时水平最高．2周后逐渐恢复；ACYD并MOF重型患者（MOF积分＞4分）PRL、GH水平显著高于轻型患者（MOF积分≤4分）。结果提示PRL、GH可能参与了ACVD并MOF的病理生理过程。