急性颅脑损伤后垂体前叶激素的动态变化及意义

目的探讨急性颅脑损伤患者垂体前叶激素水平的变化与颅脑损伤程度及预后的关系。方法随机抽取90例颅脑损伤患者作为观察组,采用酶联免疫定量分析法动态检测伤后第1、3、5、7、14、30d血清催乳素(PRL)、卵泡刺激素(FSH)、黄体生成激素(LH)和促甲状腺激素(TSH)水平;30例正常人作对照组,损伤程度采用GCS评分评估,预后采用GOS评分评估。结果观察组血清PRL、FSH、LH较对照组显著升高(P<0.05),TSH较对照组略降低(P>0.05);观察组血清PRL、FSH、LH水平伤后升高(72h内尤为明显),后逐渐降低,血清TSH的水平伤后略降低,后逐渐回升;GCS评分较低者垂体前叶激素变化幅度较大;预后恶劣的颅脑损伤患者垂体前叶激素变化幅度较大。结论急性颅脑损伤后血清垂体前叶激素PRL、FSH及LH水平明显升高,变化程度与颅脑损伤严重程度及预后有关。

Dynamical changes of anterior pituitary hormones in acute craniocerebral trauma patients

Objective To explore the correlation of changes in the anterior pituitary hormones with the severity and prognosis in patients with craniocerebral trauma.Methods The dynamical levels of changes in serum prolactin(PRL),follicle stimulating homone(FSH),luleinizing hormone(LH),and throid stimulating hormone were studied in 90 undergoing craniotomy patients with acute head injury in first,third,fifth,seventh,fourteenth,thirtieth day after trauma.Sixty normal persons were compared as control group.The severity and the prognosis were assessed respectively by GCS and GOS.Results In the acute phase of craniocerebral injury,the serum PRL,FSH and LH were significantly increased(P<0.05),and TSH was little decreased(P>0.05).The serum level of PRL,FSH and LH in observed group were increased after trauma(especially significant in 72 hours) and decreased gradually.The serum level of TSH in observed group were decreased after trauma and increased gradually.The severer brain injury was,the more obviously the hormones changed.The worse the prognosis was,the more obviously the hormones changed.Conclusion The serum level of anterior pituitary hormones PRL,FSH and LH increase significantly,the changes are related to the severity and the prognosis in patients with craniocerebral injury.