原发性甲状腺功能减退致垂体增生的诊断与治疗

目的探讨原发性甲状腺功能减退致垂体增生的诊断和治疗原则。方法回顾性分析3例原发性甲状腺功能减退致垂体增生患者的临床资料。对3例原发性甲状腺功能减退患者行垂体及靶腺功能和影像学检查，并在左旋甲状腺素替代治疗l～3个月后行内分泌功能及MRI复查。结果3例均为原发性甲状腺功能减退症，MRI示垂体明显增大，信号强化均匀。左旋甲状腺素替代治疗3个月后甲状腺功能减退症状消失；MRI示垂体大小恢复正常2例，明显缩小1例；血浆甲状腺素、促甲状腺素和泌乳素水平恢复正常。结论原发性甲状腺功能减退病人可以伴有垂体增生；努力提高对其垂体增生MRI表现的认识，及时诊断，并首选甲状腺素替代治疗效果好。

Diagnosis and management of pituitary hyperplasia due to primary hypothyroidism

Objective To explore the diagnosis and management of pituitary hyperplasia due to primary hypothyroidism. Methods The clinical data of 3 primary hypothyroidism patients with pituitary hyperplasia, who received endocrinology and MRI examinations on admission to hospital, were analyzed retropeetively. The endocrinology and MR1 examinations were performed again 1-3 months after the treatment with L-thyvoxine in all the patients. Results The primary hypothyroidism and pituitary hyperplasia were definitely diagnosed respectively by the endocrinology and MRI examinations. The hypothyroidism symptoms disappeared and the volumes of the pituitary gland returned to the normal in 2 patients and decreased in 1 patient 3 months after the treatment, when the plasma levels of thyroxin, thyroid stimulating hormone and prolactin returned to the normal. Conclusions The pituitary hyperplasia may exist in the patients with the primary hypothyroidsm. The substitutive therapy with thyroxine is an effective method to treat the primary hypothyroidism- associated pituitary hyperplasia.