流行性出血热下丘脑-垂体、甲状腺、肾上腺皮质功能的变化及其意义

对229例EHF患者进行了下丘脑-垂体、甲状腺和肾上腺皮质功能的研究,发现血清PRL、GH、TSH以及血浆F在病程早期和极期有不同程度的增高倾向,多尿期以后逐渐恢复正常。垂体功能试验表明下丘脑-垂体-肾上腺皮质轴及PRL分泌细胞储备功能基本正常,重型和危重型病例血清TT_3下降而rT_3升高,可能是肝、肾功能受损使血清T_4代谢障碍的结果。适当使用免疫调节剂、胰岛素并及时调正内环境可能对患者有利。

FUNCTIONAL CHANGES OF HYPOTHALAMUS, ANTERIOR PITUITARY, THYROID, AND ADRENAL CORTEX IN EHF AND THEIR CLINICAL SIGNIFICANCE

The functions of hypothalamus, anterior pituitary, thyroid, and adrenal cortex were studied in 299 cases with epidemic hemorrhagic fever (EHF). It was found that the serum PRL, GH, TSH and plasma cortisol were significantly higher at early stage and returned to normal when diuresis occurred. Pituitary function tests showed that the hypo-thalamic-pituitary-adrenocortical axis and prolactin secretion were intact, while the hypothalamic-pituitary-thyroid axis and GH secretion were somewhat impaired. In severe cases there were low T3 syndrome associated with increased rT3 level. We concluded that the augmented secretion of PRL, GH, cortisol and catecholamines may be due to a stress which, might be responsible for the insulin resistance and decreased immunological function. Therefore, the use of immune-potentiating agents, insulin, and drugs such as phentolamine, propranolol might be beneficial.