垂体激素水平对蛛网膜下腔出血患者临床诊断和预后的意义

目的观察蛛网膜下腔出血患者垂体激素水平的变化,探讨其对蛛网膜下腔出血临床诊断和预后的意义。方法采用血液生化自动分析仪测定58例蛛网膜下腔出血患者治疗前后和健康体检者血浆中皮质醇（COR）、促黄体生成素（LH）、生长激素（GRH）、促卵泡激素（FSH）、促甲状腺激素（TSH）、泌乳素（PRL）水平。结果蛛网膜下腔出血男性和女性患者治疗前后血浆COR、LH、GRH、FSH和PRL水平相比均具有统计学差异（P均〈0.05）,TSH水平无统计学差异（P均〉0.05）。以Hunt和Hess评级系统进行评级,Ⅲ~Ⅴ级蛛网膜下腔出血患者治疗前COR、LH、FSH和PRL水平与0~Ⅱ级患者相比升高,GRH水平下降（P均〈0.05）,TSH水平无统计学差异（P〉0.05）。结论蛛网膜下腔出血患者常伴随垂体激素分泌异常状态,检测其体内的COR、LH、GRH、FSH和PRL水平对蛛网膜下腔出血的临床诊断和预后判断具有重要意义。

Hypophysial hormone level in patients with subarachnoid hemorrhage and its clinical significance

Objective To investigate the hypophysial hormone level in patients with subarachnoid hemorrhage and discuss the clinical significance.Methods Totally 58 subarachnoid hemorrhage patients were recruited for this study.The cortisol（COR）,luteinizing hormone（LH）,growth hormone（GRH）,follicle stimulating hormone（FSH）,thyroid stimulating hormone（TSH）,prolactin（PRL） levels before and after therapy,were determined by blood biochemical automatic analyzer.Results The mean levels of COR,LH,GRH,FSH and PRL of male and female patients before therapy were different significantly compared to those after therapy（all P〈0.05）,TSH level was not significantly different（all P〈0.05）.With Hunt and Hess rank,the mean levels of COR,LH,FSH and PRL of male and female patients before therapy of class Ⅲ ~ Ⅴ were increased,the level of GRH was decreased compared to the patients of class 0 ~ Ⅱ,TSH level was not significantly different（P〉0.05）.Conclusion Patients with subarachnoid hemorrhage are frequently associated with an abnormal hypophysial hormone level,therefore the monitor of COR,LH,GRH,FSH and PRL level in patients is of great importance to subarachnoid hemorrhage screening.