男性颅脑创伤后神经内分泌改变研究

目的 观察中、重型男性颅脑创伤(TBI)患者伤后血清神经内分泌激素变化.方法 选取我院收治的GCS 12分以下男性患者95例(排除内分泌疾病史),分别于伤后第1、3、7、14、21天采取静脉血,收集血清置于-80℃冰箱保存,统一应用全自动化学发光仪进行PGN、COR、T3、T4、E2、TES、FSH、GH、INS、LH、PRL、TSH、ACTH的检测.以正常值作为参照,计算各个时间点高于、低于正常值的发生率.结果 中、重型颅脑创伤男性患者内分泌发生改变的概率较高,其中甲状腺功能类激素多表现降低后逐步向正常范围恢复;FSH和LH可高可低,但多数异常者表现为增高;PRL表现异常者主要是增高;E2异常者表现为伤后增高;PGN异常者主要表现一过性增高;INS异常者主要表现为增高;GH异常者存在明显的增高;COR异常者主要表现为增高,但也有少数患者COR不升反降;TES异常者存在明显降低;ACTH异常者主要表现为增高.结论 男性颅脑创伤后神经内分泌发生改变的概率高,进行相关治疗将促进患者恢复.

Study on neuroendocrine changing of post-TBI

Objective To observe the change of the male patient's neuroendocrine hormone in serum after medium and severe TBI.Method 95 male patients were selected from our hospital and their GCS were all under 12(without endocrine disease).They were phlebotomized 1 d,3 d,7 d,14 d,21 d after injury and we preserved their serum in refrigerator under-80℃ after centrifugalization.PGN,COR,T3,T4,E2,TES,FSH,GH,INS,LH,PRL,TSH,ACTH were detected by the automate chemiluminescence machine.According to the reference ranges,the indexes detected at different times can be classified and with calculation we got the rate which may be higher,lower than the normal level demonstrated by the diagram.Results The rate of the change which occured at the male patient's endocrine hormones after medium and severe TBI is high.The levels of T3,T4 mostly decreased at first,then restored to the normal level:FSH and LH may be high or low,mostly showed to increase:PRL and E2 demonstrated to increase:PGN increased only for a short time;INS abnormal patient mainly increased;GH increased obviously;COR mainly increased,but at a few circumstance it may decreased:TES decreased obviously:ACTH abnormal patient mainly increased.Conclusions The rate of the neuroendocrine changes which occurred after TBI is high and it will accelerate the recovery of the patients after taking the related therapies.