脑损伤后内分泌功能的变化及其发生机制

在创伤性颅脑损伤和脑血管病急性期，均可出现下丘脑-垂体．肾上腺皮质轴、下丘脑-垂体-甲状腺轴和下丘脑-垂体-性腺轴功能紊乱，主要是由于下丘脑和垂体原发或继发性损伤所致。脑损伤后急性期的体内大多数激素水平的变化是暂时性的，也可能是可逆的，但部分病例在恢复期合并有垂体功能减退，出现分泌功能不足的表现。激素的缺乏可能会影响到脑损伤患者的预后，目前需要建立一个指南以明确哪部分患者、什么时候以及怎样进行激素替代治疗。

Variations of Endocrine after Brain Injuries and Its Neuropathological Mechanism(review)

In the acute phase of traumatic brain injury or cerebrovascular disease, disorders of hypothalamic-pituitary-cortical axis, hypothalamic-pituitary-thyroid axis and hypothalamic-pituitary-gonad axis may exist. The main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury. Most of the variations of endocrine after acute brain injuries may be temporary and reversible, but some patients will accompany with hypopituitarism or neuroendocrine deficiency. It is important to set a guideline to decide who and when to test. Hormone replacement therapy should also be verified if it can improve the outcome of patients with brain injuries.