自发性脑室出血对下丘脑-垂体轴功能的影响

目的探讨自发性脑室出血对下丘脑-垂体轴功能的影响。方法对32例自发性脑室出血病人(脑室出血组)出血后1、14、30 d的血清胰岛素样生长因子-1(IGF-1)、促肾上腺皮质激素(ACTH)、泌乳素、卵泡刺激素(FSH)、黄体生成素(LH)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平进行测定,并与21例健康成年人(正常对照组)相应激素水平进行比较,对自发性脑室出血病人激素异常情况及其动态变化进行分析。结果自发性脑室出血病人中激素分泌异常发生率为40.6%,出血后1 d脑室出血组的激素水平与正常对照组相比差异没有统计学意义(均P>0.05);出血后14 d,与正常对照组相比,脑室出血组IGF-1水平明显降低(P<0.05),泌乳素水平明显上升(P<0.05),且均持续到第30天;ACTH水平在出血后30 d时明显低于正常对照组(P<0.05)。结论脑室出血对下丘脑-垂体轴神经内分泌功能有明显影响。动态监测这类病人神经内分泌变化,必要时采取激素替代治疗可能有助于改善病人的预后及生存质量。

Effect of spontaneous intraventricular hemorrhage on the function of hypothalamic-pituitary axis

Objective To explore the effect of spontaneous in~aventricular hemorrhage （SIH） on the function of hypothalamic-pituitary axis. Methods Thirty-two SIH patients were set as SIH group. The endocrine hormones such as insulin-like growth factor-1 （IGF-1）, adrenocorticotropic hormone （ACTH）, prolactin, follicle-stimulating hormone, luteinizing hormone, free thyroxine and thyroid stimulating hormone level in serum were detected 1, 14, 30 d after hemorrhage in SIH group. Twenty-one healthy adults were set as normal control group and the correspondent endocrine hormones were detected in order to compare with SIH group. The abnormality and dynamic changes of endocrine hormones of patients in SIH group were analyzed. Results The incidence of hormone abnormality was 40.6% in SIH group. There was no obvious difference in hormone level between the two groups 1 d after hemorrhage （all P 〉 0.05）. Compared with normal control group, IGF-1 level decreased and PRL level increased obviously in the SI]-I group from 14 to 30 d after hemorrhage （all P 〈 0.05）, and ACTH level decreased significantly 30 d after hemorrhage （P 〈 0.05）. Conclusions SIH has obvious influence on the endocrine function of hypothalamic-pituitary axis. The dynamic monitoring of neuroendocrine status and hormone replacement therapy if necessary may improve the prognosis and life quality of patients.